IMPACT OF PREOPERATIVE ATRIAL FIBRILLATION IN PATIENTS WITH LEFT VENTRICULAR ASSIST DEVICE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Pakpoom Tantrachoti; Saranapoom Klomjit; Wasawat Vutthikraivit; Pattara Rattanawong; Pavida Pachariyanon; Passisd Laoveeravat; Subhanudh Thavaraputta; Nandini Nair

doi:10.1016/S0735-1097(18)31510-9

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IMPACT OF PREOPERATIVE ATRIAL FIBRILLATION IN PATIENTS WITH LEFT VENTRICULAR ASSIST DEVICE: A SYSTEMATIC REVIEW AND META-ANALYSIS

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IMPACT OF PREOPERATIVE ATRIAL FIBRILLATION IN PATIENTS WITH LEFT VENTRICULAR ASSIST DEVICE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Pakpoom Tantrachoti, Saranapoom Klomjit, Wasawat Vutthikraivit, Pattara Rattanawong, Pavida Pachariyanon, Passisd Laoveeravat, Subhanudh Thavaraputta and Nandini Nair

Journal of the American College of Cardiology, Vol.71(11 Supplement), pp.A969-A969

03/10/2018

DOI: 10.1016/S0735-1097(18)31510-9

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Abstract

Background Atrial fibrillation (AF) is commonly found in candidates of left ventricular assist device (LVAD). A large INTERMACS study suggests that AF may not increase mortality on midterm follow-up (median time 8.5 months; IQR 4.6-13.5 months), while some of the other studies that follow the patients longer show increased mortality. Our study aims to clarify this discrepancy. Methods We searched the database of MEDLINE and EMBASE from inception to October 2017. The eligible studies report stroke and all-cause mortality in LVAD patients and compare clinical outcomes between AF and non-AF(NAF) patients who received LVAD. Data was analyzed using the random-effects, generic inverse variance method of DerSimonian and Laird. Results Six retrospective studies from 2013-2017 were included involving 1,549 LVAD patients (AF 603, NAF 946). The follow-up period ranged from 2-4 years. Patients with preoperative AF have significantly higher mortality rate compared to NAF patients (pooled risk ratio=1.28, 95 % confidence interval: 1.06-1.54, p=0.009, I2=48.8%) (figure 1.1). There was no statistically significant difference in stroke incidence between the two groups (pooled risk ratio=1.05, 95 % confidence interval: 0.73-1.51, p=0.804, I2=0.0%) (figure1.2). Conclusion Our study shows that preoperative AF might be associated with higher mortality rate in the long-term. Future prospective studies are recommended to further validate the result.

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Title: Subtitle: IMPACT OF PREOPERATIVE ATRIAL FIBRILLATION IN PATIENTS WITH LEFT VENTRICULAR ASSIST DEVICE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Creators: Pakpoom Tantrachoti - Texas Tech University Health Sciences Center
Saranapoom Klomjit - Texas Tech University Health Sciences Center
Wasawat Vutthikraivit - Texas Tech University Health Sciences Center
Pattara Rattanawong - Texas Tech University Health Sciences Center
Pavida Pachariyanon - Texas Tech University Health Sciences Center
Passisd Laoveeravat - Texas Tech University Health Sciences Center
Subhanudh Thavaraputta - Texas Tech University
Nandini Nair - Texas Tech University Health Sciences Center
Resource Type: Abstract
Publication Details: Journal of the American College of Cardiology, Vol.71(11 Supplement), pp.A969-A969
DOI: 10.1016/S0735-1097(18)31510-9
ISSN: 0735-1097
eISSN: 1558-3597
Publisher: ELSEVIER SCIENCE INC
Language: English
Date published: 03/10/2018
Academic Unit: Internal Medicine
Record Identifier: 9984695814102771

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