The safety and efficacy of second-generation cryoballoon ablation plus catheter ablation for persistent atrial fibrillation: A systematic review and meta-analysis.
The safety and efficacy of second-generation cryoballoon ablation plus catheter ablation for persistent atrial fibrillation: A systematic review and meta-analysis.
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第二代冷冻球囊消融联合导管消融治疗持续性房颤的安全性和有效性：系统评价和荟萃分析
DOI：
10.1371/journal.pone.0206362
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Zhou X
中科院分区：
文献类型：
--
作者：
Shao M;Shang L;Shi J;Zhao Y;Zhang W;Zhang L;Li Y;Tang B;Zhou X
越来越多的证据表明，第二代冷冻球囊消融术（2G-CB）对持续性房颤（PerAF）患者有效。房颤（AF）消融的基础是肺静脉隔离（PVI）。本研究旨在总结PerAF患者中使用2G-CB的“仅肺静脉隔离”策略与“肺静脉隔离+”策略的安全性和中期（≥ 12个月）有效性的可用数据。我们检索了PubMed、EMBASE和科克伦图书馆数据库中关于2G-CB治疗PerAF的研究。组分析基于消融方法：“仅肺静脉隔离”与“肺静脉隔离+”，后者涉及肺静脉隔离+其他基质改良。纳入了显示≥ 12个月随访（FU）时临床成功率的研究。并发症发生率也进行了评估。通过应用固定效应模型分析数据。共分析了来自5项研究的879例患者。27个月中期随访后，2G-CB治疗PerAF的总体成功率为66.1%。在“PVI+”组中，成功率为73.8%。在“仅PVI”组中，成功率为53.6%。研究间未观察到异质性（I2 = 0.0%，P = 0.82）。并发症发生率为5.2%（P = 0.93），膈神经损伤发生率为2.8%（P = 0.14）。血管评估并发症最常见，为1.6%（P = 0.33）。未报告死亡或心肌梗死。涉及2G-CB的“PVI-plus”治疗PerAF似乎是安全有效的。
Growing evidence suggests that second-generation cryoballoon ablation (2G-CB) is effective in patients with persistent atrial fibrillation (PerAF). The cornerstone of atrial fibrillation (AF) ablation is pulmonary vein isolation (PVI). The purpose of this study was to summarize the available data on the safety and mid-term (≥ 12 months) effectiveness of a ‘PVI-only’ strategy vs. a ‘PVI-plus’ strategy using 2G-CB in patients with PerAF. We searched the PubMed, EMBASE and Cochrane library databases for studies on 2G-CB for PerAF. Group analysis was based on the ablation approach: ‘PVI-only’ versus ‘PVI-plus’, the latter of which involved PVI plus other substrate modifications. Studies showing clinical success rates at a follow-up (FU) of ≥ 12 months were included. Complication rates were also assessed. Data were analyzed by applying a fixed effects model. A total of 879 patients from 5 studies were analyzed. After a mid-term FU of 27 months, the overall success rate of 2G-CB for PerAF was 66.1%. In the ‘PVI-plus’ group, the success rate was 73.8%. In the ‘PVI-only’ group, the success rate was 53.6%. No heterogeneity was noted among studies (I2 = 0.0%, P = 0.82). Complications occurred in 5.2% of patients (P = 0.93), and the rate of phrenic nerve (PN) injury was 2.8% (P = 0.14). Vascular assess complications were the most frequent at 1.6% (P = 0.33). No death or myocardial infarction was reported. ‘PVI-plus’ involving 2G-CB seems to be safe and effective for treating PerAF.
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影响因子：
3
作者：
Rizzo, Maria Rosaria;Sasso, Ferdinando Carlo;Paolisso, Giuseppe
通讯作者：
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影响因子：
3.4
作者：
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作者：
Nair, Girish M;Nery, Pablo B;Birnie, David H
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