Abstract
This meta-analysis compared the efficacy and safety of the contact force (CF)-sensing catheter and second-generation cryoballoon (CB) ablation for treating atrial fibrillation (AF). Six controlled clinical trials comparing ablation for AF using a CF-sensing catheter or second-generation CB were identified from PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure. The procedure duration was significantly lower in the CB group compared with that in the CF group [mean difference (MD)=29.4; 95%CI=17.84–40.96; P=0.01], whereas there was no difference between the groups for fluoroscopy duration (MD=0.59; 95%CI=–4.48–5.66; P=0.82). Moreover, there was no difference in the incidence of non-lethal complications (embolic event, tamponade, femoral/subclavian hematoma, arteriovenous fistula, pulmonary vein stenosis, phrenic nerve palsy, and esophageal injury) between the CB and the CF groups (8.38 vs 5.35%; RR=0.66; 95%CI=0.37–1.17; P=0.15). Transient phrenic nerve palsy occurred in 17 of 326 patients (5.2%) of the CB group vs none in the CF group (RR=0.12; 95%CI=0.03–0.43; P=0.001). A comparable proportion of patients in CF and CB groups suffered from AF recurrence during the 12-month follow-up after a single ablation procedure [risk ratio (RR)=1.03; 95%CI=0.78–1.35; P=0.84]. AF ablation using CF-sensing catheters and second-generation CB showed comparable fluoroscopy duration and efficacy (during a 12-month follow-up), with shorter procedure duration and different complications in the CB group.
Highlights
Atrial fibrillation (AF) is the most common sustained atrial arrhythmia, affecting over 5 million patients, and is often associated with dramatic adverse effects on quality of life and decreased survival [1,2]
contact force (CF) ablation for the treatment of AF is more efficacious than antiarrhythmic drug therapy with a lower rate of complications [5,6]
Publication bias No significant publication bias was found for the primary outcome (AF recurrence at follow-up) as assessed by a funnel plot (Figure 2)
Summary
Atrial fibrillation (AF) is the most common sustained atrial arrhythmia, affecting over 5 million patients, and is often associated with dramatic adverse effects on quality of life and decreased survival [1,2]. Drug therapy provides limited relief from arrhythmia and carries the risk of multiple side effects. Catheter ablation has been shown to be effective in decreasing recurrent atrial fibrillation. The novel cryoballoon (CB) and contact force (CF)-sensing catheter are revolutionizing the field of atrial fibrillation ablation [4]. Radiofrequency (RF) catheter ablation using CF-sensing potentially results in effective ablation. CF ablation for the treatment of AF is more efficacious than antiarrhythmic drug therapy with a lower rate of complications [5,6]. Recent studies suggest that CF-sensing catheter usage reduces procedural time, and X-ray exposure [5,7,8]
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Schedule a callMore From: Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas
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