Background: This meta-analysis aimed to compare the effectiveness of early rhythm control to rate control, and whether catheter ablation derived more benefit compared to other methods of rhythm control.
Methods: A comprehensive literature search was conducted on PubMed, SCOPUS, and EuropePMC up to July 2, 2024. The primary outcome of this study was major adverse cardio-cerebrovascular events (MACCE), defined as a composite of mortality, stroke/systemic embolism, heart failure hospitalization (HFH), and acute coronary syndrome (ACS) during the follow-up period. Outcome measures were adjusted hazard ratios (aHR).
Results: A total of 504,124 patients from 11 studies were included in this systematic review and meta-analysis. Early rhythm control was significantly associated with reduction in MACCE (aHR 0.85 [95 % CI 0.80, 0.90], p < 0.001; I: 23 %), stroke (aHR 0.79 [95 % CI 0.72, 0.86], p < 0.001; I: 25 %), HFH (aHR 0.87 [95 % CI 0.78, 0.96], p = 0.008; I: 48 %), and ACS (aHR 0.80 [95 % CI 0.66, 0.96], p = 0.018; I: 40 %). No mortality benefit (aHR 0.93 [95 % CI 0.85, 1.01], p = 0.066; I: 67 %) was observed; however, mortality benefit became evident (aHR 0.87 [95 % CI 0.85, 0.89], p < 0.001) upon removal of a study during a leave-one-out sensitivity analysis. Meta-regression analysis showed that the benefits of early rhythm control in terms of MACCE were more pronounced with ablation (coefficient -0.004, p = 0.010, R: 100 %).
Conclusion: Early rhythm control was associated with better outcomes compared to rate control in AF, with a more pronounced benefit observed for ablation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ipej.2025.02.003 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Personalization of Cancer Treatment: Exploring the Role of Chronotherapy in Immune Checkpoint Inhibitor Efficacy.
Cancers (Basel)
February 2025
Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA.
In the era of precision medicine, mounting evidence suggests that the time of therapy administration, or chronotherapy, has a great impact on treatment outcomes. Chronotherapy involves planning treatment timing by considering circadian rhythms, which are 24 h oscillations in behavior and physiology driven by synchronized molecular clocks throughout the body. The value of chronotherapy in cancer treatment is currently under investigation, notably in the effects of treatment timing on efficacy and side effects.
View Article and Find Full Text PDFCamera-based evaluation of deep breathing effects on plantar foot microcirculation - A pilot study on young healthy.
Comput Biol Med
March 2025
Dept. of Electromagnetic and Biomedical Engineering, Faculty of Electrical Engineering and Information Technology, University of Zilina, Zilina, Slovakia. Electronic address:
Background: Microvascular function, particularly of the plantar foot, reflects overall vascular health and is influenced by physiological oscillators such as heart rate, respiratory, myogenic, and neurogenic rhythms. Slow deep breathing modulates autonomic nervous system activity and affects peripheral microcirculation. This study investigates the effects of slow deep breathing on plantar foot perfusion using photoplethysmography imaging (PPGI).
View Article and Find Full Text PDFCardiovascular Risk and Plasma N-terminal Pro-B-type Natriuretic Peptide in Adults With Resistance to Thyroid Hormone β.
J Endocr Soc
March 2025
Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK.
Purpose: People with resistance to thyroid hormone due to defective thyroid receptor β (RTHβ) exhibit adverse cardiovascular outcomes and premature mortality. Whether this reflects increased global cardiovascular disease (CVD) risk or hyperthyroxinemia-associated effects on cardiac rhythm and contractility is unknown. We determined CVD risk and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations as a marker of reduced cardiac function in 99 individuals (mean age 41 years, 37% males) with RTHβ.
View Article and Find Full Text PDFApplication of Machine Learning for Patients With Cardiac Arrest: Systematic Review and Meta-Analysis.
J Med Internet Res
March 2025
Department of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Background: Currently, there is a lack of effective early assessment tools for predicting the onset and development of cardiac arrest (CA). With the increasing attention of clinical researchers on machine learning (ML), some researchers have developed ML models for predicting the occurrence and prognosis of CA, with certain models appearing to outperform traditional scoring tools. However, these models still lack systematic evidence to substantiate their efficacy.
View Article and Find Full Text PDFEarly Rhythm Control for Atrial Fibrillation in Patients With End-Stage or Chronic Kidney Disease.
Mayo Clin Proc
March 2025
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address:
Objective: To investigate the benefits and risks of early rhythm control (ERC) in patients with atrial fibrillation (AF) and chronic kidney disease (CKD).
Patients And Methods: This population-based cohort study included 5224 patients with AF (58.2% male, median age 70 years) with end-stage kidney disease (ESKD; n=1660) and CKD stage 3 to 4 (n=3564), who underwent ERC or rate control between January 1, 2005, and December 31, 2015.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!