Comparative efficacy and safety of contact force- sensing catheter and second-generation cryoballoon ablation for atrial fibrillation: a meta-analysis
Comparative efficacy and safety of contact force- sensing catheter and second-generation cryoballoon ablation for atrial fibrillation: a meta-analysis
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接触力传感导管与第二代冷冻球囊消融术治疗房颤的疗效和安全性比较：荟萃分析
DOI：
10.1590/1414-431x201764
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发表时间：
2017
影响因子：
2.3
通讯作者：
B. Tang
中科院分区：
文献类型：
--
作者：
X. Zhou;W. Lv;W. Zhang;Y. Ye;Y. Li;Q. Zhou;J. Zhang;Q. Xing;Y. Lu;L. Zhang;H. Wang;W. Qin;B. Tang
本荟萃分析比较了接触力（CF）感应导管和第二代冷冻球囊（CB）消融治疗心房颤动（AF）的疗效和安全性。我们从PubMed、EMBASE、Cochrane图书馆、万方数据和中国国家知识基础设施检索了6项对照临床试验，比较使用cf传感导管或第二代CB消融房颤。与CF组相比，CB组的手术时间明显缩短[mean difference (MD)=29.4；95%可信区间= 17.84 - -40.96;P=0.01]，而两组间透视时间无差异（MD=0.59; 95%CI= - 4.48 ~ 5.66； P=0.82）。此外，非致死性并发症（栓塞事件、心包填塞、股/锁骨下血肿、动静脉瘘、肺静脉狭窄、膈神经麻痹、食管损伤）的发生率在CB组和CF组之间无差异（8.38 vs 5.35%； RR=0.66; 95%CI=0.37 ~ 1.17； P=0.15）。326例患者中，CB组有17例（5.2%）发生短暂性膈神经麻痹，CF组无（RR=0.12; 95%CI= 0.03-0.43； P=0.001）。CF组和CB组患者在单次消融手术后12个月随访期间发生房颤复发的比例相当[风险比(RR)=1.03；95%可信区间= 0.78 - -1.35;P = 0.84)。使用cf感应导管和第二代CB的房颤消融显示出相当的透视时间和疗效（在12个月的随访期间），CB组的手术时间更短，并发症不同。
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.