Cavotricuspid isthmus ablation for atrial flutter guided by contact force related parameters: A systematic review and meta-analysis.
Cavotricuspid isthmus ablation for atrial flutter guided by contact force related parameters: A systematic review and meta-analysis.
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DOI：
10.3389/fcvm.2022.1060542
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发表时间：
2022
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
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贴靠力（CF）和相关参数已被评价为肺静脉隔离的有效指导标志，但不适用于三尖瓣环峡部（CTI）依赖性房扑（AFL）的线性消融。因此，我们研究了CF相关参数引导消融治疗CTI-AFL的有效性和安全性。对涉及PubMed、EMbase、科克伦图书馆和Web of Science的数据库进行了系统检索（截至2022年6月）。纳入了比较CF相关参数引导消融与传统参数引导消融治疗CTI-AFL的原始文章。研究间异质性检验采用逐一剔除法、亚组分析和Meta回归分析。根据入选和排除标准筛选后，确定了10项报告761例患者的研究。CF相关参数引导组的射频（RF）持续时间显著更短（p = 0.01），而两组的手术时间（p = 0.13）和透视时间（p = 0.07）无显著差异。CF相关参数引导组的射频损伤较少（p = 0.0003），导管组织的CF较大（p = 0.0002）。CF相关参数引导组中，第一条消融线后需要的修补较少（p = 0.004）。此外，两组的急性传导恢复率（p = 0.25）、复发率（p = 0.92）和并发症发生率（p = 0.80）无统计学意义。Meta回归分析显示，无特定协变量作为上述结果的影响因素（p > 0.10）。与常规方法相比，CF相关参数指导提高了CTI消融的效率，具有更好的导管-组织接触，更短的射频持续时间和相当的安全性，但并未提高即刻成功率和长期结局。
Contact force (CF) and related parameters have been evaluated as an effective guide mark for pulmonary vein isolation, yet not for linear ablation of the cavotricuspid isthmus (CTI) dependent atrial flutter (AFL). We thus studied the efficacy and safety of CF related parameter-guided ablation for CTI-AFL. Systematic search was performed on databases involving PubMed, EMbase, Cochrane Library and Web of Science (through June 2022). Original articles comparing CF related parameter-guided ablation and conventional parameter-guided ablation for CTI-AFL were included. One-by-one elimination, subgroup analysis and meta-regression were used for heterogeneity test between studies. Ten studies reporting on 761 patients were identified after screening with inclusion and exclusion criteria. Radiofrequency (RF) duration was significantly shorter in CF related parameter-guided group (p = 0.01), while procedural time (p = 0.13) and fluoroscopy time (p = 0.07) were no significant difference between two groups. CF related parameter-guided group had less RF lesions (p = 0.0003) and greater CF of catheter-tissue (p = 0.0002). Touch-up needed after first ablation line was less in CF related parameter-guided group (p = 0.004). In addition, there were no statistical significance between two groups on acute conduction recovery rates (p = 0.25), recurrence rates (p = 0.92), and complication rates (p = 0.80). Meta-regression analysis revealed no specific covariate as an influencing factor for above results (p > 0.10). CF related parameters guidance improves the efficiency of CTI ablation, with the better catheter-tissue contact, the lower RF duration and the comparable safety as compared with conventional method, but does not improve the acute success rate and long-term outcome.
影响因子：
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作者：
Saraf, Karan;Black, Nicholas;Garratt, Clifford J;Muhyaldeen, Sahrkaw A;Morris, Gwilym M
通讯作者：
Morris, Gwilym M