Abstract
BackgroundThe ThermoCool Smarttouch Surroundflow catheter (STSFc) is an advanced catheter, which integrating contact force sensing and surroundflow technology. However, comparative data between STSFc and contact force sensing catheter (Thermocool SmartTouch catheter [STc]) are limited.HypothesisWe thought that STSFc might bring more clinical benefits. The aim of this meta‐analysis was to compare the safety and efficiency between the STSFc and the STc for treatment of atrial fibrillation (AF).MethodsThe Medline, PubMed, Embase, and Cochrane Library databases were searched for studies comparing STSFc and STc.ResultsFour trials involving 727 patients were included in the study. Pool‐analyses demonstrated that, as compared STc ablation, STSFc ablation was more beneficial in terms of procedural times (standard mean difference [SMD]: −0.22; 95% confidence interval [CI], −0.37 to −0.07, P = .005) and irrigation fluid volume (SMD: −1.94; 95% CI, −2.65 to −1.22, P < .0001). There was no significant difference between STSFc and STc (risk ratio [RR]: 1.02; 95% CI: 0.86 to 1.21, P = .79) for free from AF. Evidence of complications were low and similar for both groups (RR: 0.83; 95% CI: 0.19‐3.55, P = .80). Additionally, patients administered STSFc ablation tended to have shorter fluoroscopic times (SMD: −0.20; 95% CI, −0.63‐0.23, P = .21).ConclusionsSTSFc ablation was associated with reducing procedural times and irrigation fluid volume. Further, STSFc ablation tended to shorten fluoroscopic times. Therefore, STSFc ablation would be a better choice for AF patients especially in patients with heart failure.
Highlights
Atrial fibrillation (AF) is the most common sustained arrhythmia.[1]
The pooled analysis demonstrated that Smarttouch Surroundflow catheter (STSFc) ablation significantly reduced procedure times (SMD: −0.22; 95% confidence intervals (CIs), −0.37 to −0.07, P = .005; I2 = 0%; Figure 2A)
The main findings from the pooled analysis were as follows: (a) STSFc ablation can reduce procedure times and irrigation fluid volume as compared to Thermocool SmartTouch catheter (STc) ablation; (b) no differences were found in terms of the proportion of patients free from atrial fibrillation (AF) between the STSFc and STc groups; (c) STSFc ablation has a tendency to shorten the fluoroscopic times, the difference is no significant; (d) the ablation times, and complications rates were similar for both groups
Summary
Atrial fibrillation (AF) is the most common sustained arrhythmia.[1]. Advances in electro-physiological technology and increased operator experience over the last decade have permitted catheter ablation to emerge as standard therapy for symptomatic, drug-refractory AF.[2,3] obtaining long-term PVs electrical isolation remains challenging with just a single procedure.[4]. CF-sensing catheters have been developed that can directly quantify tissue contact and provide real-time data to guide ablation. The surround flow (SF) entire tip irrigation system features a wide-spread distribution of the irrigating solution (56 irrigation holes), which enables homogenous cooling, protection from thrombus formation with lower flow rate requirements, and reduce incidence of steam pops.[6,10]. Both technologies have been widely adopted individually: the Thermocool SmartTouch catheter (STc, Biosense Webster, Diamond Bar) and the ThermoCool SurroundFlow catheter (SFc, Biosense Webster, Diamond Bar, CA). We pursue a meta-analysis to evaluate the clinical benefits of STSFc as compared with STc
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