术前超重/肥胖对心房颤动导管消融术后晚期复发影响的荟萃分析

The impact of preoperative overweight or obesity on late recurrence of atrial fibrillation after catheter radiofrequency ablation: a meta-analysis

目的 本文旨在系统评价术前超重/肥胖对心房颤动(房颤)射频导管消融术后晚期复发的影响.方法 在PubMed、Embase、Web of Science、CBM、CNKI、维普期刊、万方数据库中检索关于超重/肥胖对房颤射频导管消融术远期治疗效果影响的文献,检索时限为建库至2018年9月30日,应用Rev.Man5.3软件进行分析.结果 共纳入11篇文献,10 282例研究对象,研究结果显示术前超重/肥胖(OR=1.40,95%CI1.13~ 1.74,P=0.002)对房颤射频导管消融术后晚期复发的影响差异有统计学意义.亚组分析结果显示:与体重正常者相比,术前超重(OR=1.11,95%CI0.89~ 1.39,P=0.37)对房颤射频导管消融术后晚期复发的影响差异无统计学意义,术前肥胖(OR=1.29,95% CI1.14~1.46,P<0.0001)对房颤射频导管消融术后晚期复发的影响差异有统计学意义.但是相对于术前超重患者而言,肥胖对房颤患者射频导管消融术后晚期复发的影响差异无统计学意义(OR=1.20,95%CI0.99~1.47,P=0.07).结论 超重/肥胖会影响房颤射频导管消融术的治疗效果,增加晚期复发的风险,但是进一步分析表明超重与肥胖对房颤患者射频导管消融术治疗效果的影响差异无统计学意义.

Objective This paper aimed to systematically evaluate the effect of overweight or obesity before operation on late recurrence of trans-catheter radiofrequency ablation for atrial fibrillation.Methods We searched literature related to the impact of overweight or obesity on outcome of trans-catheter radiofrequency ablation for atrial fibrillation from data such as PubMed,Embase,Web of Science,CNKI,VIP,Wan fang and CBM,and the time limit for retrieval was from the establishment of the database to September 30 th,2018,and data analysis using Rev.Man5.3 software.Results Total of 11 studies were retrieved and 10 282 patients were included,and result of the research demonstrated that overweight/obesity (OR =1.40,95% CI 1.13-1.74,P =0.002) was a risk factor for late recurrence of trans-catheter radiofrequency ablation for atrial fibrillation.And subgroup analysis revealed that there was no statistical significance in the effect of overweight on outcome of trans-catheter radiofrequency ablation for atrial fibrillation (OR =1.11,95% CI 0.89-1.39,P=0.37) compared with normal weight.While,preoperative obesity had significant effect on late recurrence of atrial fibrillation after radiofrequency catheter ablation (OR =1.29,95% CI 1.14-1.46,P<0.0001).What's more,compared with overweight,there was no statistical significance in the effect of obesity on outcome of trans-catheter radiofrequency ablation in atrial fibrillation (OR =1.20,95% CI 0.99-1.47,P =0.07).Conclusion Overweight or obesity will impact the efficiency of catheter radiofrequency ablation for atrial fibrillation and increase the risk of late recurrence.But further analysis showed that obesity and overweight had the similar effect on the efficiency of catheter radiofrequency ablation for atrial fibrillation.