![]() ![]() Orally three doses of 60 mg Q day prior to the procedure Iv 0.5 mg/kg before the femoral vein puncture and orally 12 mg/day for the following 4 daysĪny episode of AF/AFL/AT of at least 30 s Moderate: Iv 125 mg within 30 min after RFCA Iv hydrocortisone 2 mg/kg in the day of PVI and orally prednisonlone 0.5 mg/kg/day for 3 days after PVI Symptomatic electrocardiographically documented AF or AFL, or AT, at least ≥ 30 s Intensive questioning regarding any arrhythmia relatedģ.5-mm irrigated-tip catheter, 43☌, 30–35 W, 17–30 ml/min, on the posterior wall, 20–25 W, 17 ml/min ![]() Iv 0.5 mg/kg for post-procedural day 1 and orally 12 mg/day for post-procedural days 2–5ģ.5-mm irrigated-tip catheter, 50☌, 25–35 W ![]() Iv 11.9 ± 4.6 mg/day during hospitalizationĬontinuous electrocardiographic monitoring Furthermore, the steroid administration method also varied between articles. It is worth noting that different steroids, including hydrocortisone, dexamethasone, prednisone, and methylprednisolone were used in these studies. The follow-up period varied from 6 to 38 months. Seven of eight studies examined outcomes of AF patients undergoing RFCA. The baseline characteristics of all patients are summarized in Tables 1 and 2, respectively. In the end, a total of eight studies involving 992 patients between 20 met our selection criteria for inclusion. Subsequently, we excuded 3 records of duplicated data by reading 11 full-text articles. Subsequent records including 8 animal studies, 32 case reports, 84 review articles, and 218 irrelevant studies were also excluded accordingly. Thirty-six records were discarded as duplicates. Three hundred and eighty-nine citations were initially retrieved from PubMed, Embase, and the Cochrane online database. Statistical analysisĪ flow diagram detailing the search and study selection process is illustrated in Figure 1. and M.G.) were resolved by discussion with a senior reviewer (T.L.). Any disagreements between the two reviewers (M.L. At the same time, the following data were also collected from each study: study characteristics (first author’s last name, year of publication, origin of the studied population, study population, number of patients, follow-up duration, diagnosis and detection methods of AF recurrence, ablation, dose and type of steroids in the steroids group) and patient characteristics (age, male, percentage of paroxysmal AF, hypertension, diabetes, heart failure, antiarrhythmic, echocardiographic parameters, the procedure time of catheter ablation, superior vena cava (SVC) isolation). We extracted and analyzed odd ratios (ORs)/HRs/RRs values and the corresponding 95% confidence intervals (CIs) to evaluate the association between steroids and AF recurrence after RFCA. Two reviewers extracted data from the eligibility studies according to standard data extraction forms. No clear relationship was observed for 2–3 days, 1 and 24 months of follow-up and further data are needed to clarify these results. Steroid use was associated with decreased risk of early AF recurrence 3 and 12–14 months after ablation. No clear benefit was observed for AF recurrence at 2–3 days, 1 or 24 months of follow-up. Our meta-analysis shows that steroid use was associated with reduced AF occurrence at 3 months (odd ratio (OR) = 0.53, 95% confidence interval (CI) = 0.31–0.90, P=0.02) and 12–14 months (OR = 0.67, 95% CI = 0.47–0.95, P=0.02) after radiofrequency (RF) catheter ablation (RFCA). Eight studies (four RCTs and four observational studies), with a total 992 patients, were included in the present study. Both fixed- and random-effects models were used to calculate the overall effect estimates. The primary outcome of the meta-analysis was short-term or long-term AF recurrence following a single ablation procedure with or without the use of steroids. PubMed, Embase, and Cochrane online databases were searched from inception to December 2017. Therefore, we conducted a meta-analysis of randomized clinical trials (RCTs) and observational studies to ascertain the association of steroids and AF recurrence after ablation. Previous studies have reported that steroids may reduce the risk of atrial fibrillation (AF) recurrence after catheter ablation, but data regarding this issue have been controversial.
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