The long-term efficacy of cryoballoon vs irrigated radiofrequency ablation for the treatment of atrial fibrillation: A meta-analysis
The long-term efficacy of cryoballoon vs irrigated radiofrequency ablation for the treatment of atrial fibrillation: A meta-analysis
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DOI：
10.1016/j.ijcard.2014.12.002
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发表时间：
2015-02-15
影响因子：
3.5
通讯作者：
Tang, Xuewen
中科院分区：
文献类型：
--
作者：
Cheng, Xiaocheng;Hu, Qiongwen;Tang, Xuewen
目的：本荟萃分析的主要目的是比较冷冻球囊消融（CBA）与灌注射频导管消融（RFCA）治疗房颤（AF）的长期疗效。方法：检索Medline、科克伦图书馆和Embase数据库中截至2014年10月发表的临床研究。符合我们预定纳入标准的研究被纳入。主要临床结果是患者的比例从AF（随访>= 3个月），和次要临床结果包括急性肺静脉（PV）孤立率，透视时间，手术时间和并发症。结果：经过文献检索的主要数据库，3个随机对照试验（RCT）和8个回顾性试验，共1216例患者被确定。汇总分析表明，与RFCA相比，CBA与平均16.5个月随访时无AF的患者比例相似（66.9% vs 65.1%;相对风险[RR]：1.01; 95% CI：0.94 - 1.07，P = 0.87）。急性肺静脉隔离率（RR：0.92; 95% CI：0.82 - 1.03）和透视时间（加权平均差WMD：-8.60; 95% CI：-18.29至3.69）无统计学显著差异。CBA组的手术时间较短（[ WMD]：-31.94; 95% CI：-60.43至-3.45）。短暂性膈神经麻痹仅见于CBA组（5.4%，P < 0.00001），随访期间均消退，两组总并发症相似（RR：1.30; 95% CI：0.91 - 1.85）。结论：CBA治疗房颤的长期随访与RFCA治疗房颤的疗效相当，且具有相似的手术特征。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Objectives: The main purpose of this meta-analysis was to compare the long-term efficacy of cryoballoon ablation (CBA) with irrigated radiofrequency catheter ablation (RFCA) for the treatment of atrial fibrillation (AF).Methods: The Medline, Cochrane Library and Embase Database were searched for clinical studies published up to October 2014. Studies that fulfilled our predefined inclusion criteria were included. The primary clinical outcome was the proportion of patients free from AF (follow-up >= 3 months), and the secondary clinical outcomes included acute pulmonary vein (PV) isolated rate, fluoroscopy time, procedure time and complications.Results: After a literature search in the major databases, three randomized controlled trials (RCTs) and eight retrospective trials with a total of 1216 patients were identified. Pool-analysis demonstrated that, as compared RFCA, CBA was associated with a similar proportion of patients free from AF at a mean 16.5 months follow-up (66.9% vs 65.1%; relative risk [RR]: 1.01; 95% CI: 0.94 to 1.07, P = 0.87). Acute PV isolation rate (RR: 0.92; 95% CI: 0.82 to 1.03) and fluoroscopy time (weighted mean difference WMD: -8.60; 95% CI: -18.29 to 3.69) were not statistically significant difference. The procedure time was shorter in CBA group ([ WMD]: -31.94; 95% CI: -60.43 to -3.45). Transient phrenic nerve palsy was uniquely observed in the CBA group (5.4%, P < 0.00001) and resolved in all during the follow-up period, total complication was similar in both groups (RR: 1.30; 95% CI: 0.91 to 1.85).Conclusions: CBA was as effective as RFCA for the treatment of atrial fibrillation during long-term follow-up with comparable procedural features. (C) 2014 Elsevier Ireland Ltd. All rights reserved.