Impact of contact force technology on reducing the recurrence and major complications of atrial fibrillation ablation: A systematic review and meta-analysis.
Impact of contact force technology on reducing the recurrence and major complications of atrial fibrillation ablation: A systematic review and meta-analysis.
复制标题
接触力技术对减少房颤消融复发和主要并发症的影响：系统评价和荟萃分析
DOI：
10.14744/anatoljcardiol.2016.7512
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发表时间：
2017-02
影响因子：
1.3
通讯作者：
Tang B
中科院分区：
文献类型：
--
作者：
Zhou X;Lv W;Zhang W;Ye Y;Li Y;Zhou Q;Xing Q;Zhang J;Lu Y;Zhang L;Wang H;Qin W;Tang B
接触力（CF）监测可用于完成房颤（AF）的环肺静脉（PV）隔离。本荟萃分析旨在评估CF传感导管治疗AF的有效性和安全性。从PubMed、EMBASE、科克伦图书馆、万方数据和中国国家知识基础设施（1998年1月1日-2016年）中识别了比较使用CF传感导管或标准非CF（NCF）传感导管进行AF消融的随机对照试验或非随机观察性研究。共纳入19项研究。主要疗效终点为12个月内的AF复发，与使用NCF传感导管相比，使用CF传感导管的AF复发率显著改善[31.1% vs. 40.5%;风险比（RR）=0.82; 95%置信区间（CI），0.73-0.93; p<0.05]。此外，与使用NCF传感导管相比，使用CF传感导管的急性肺静脉再连接（10.1% vs. 24.2%; RR=0.45; 95% CI，0.32-0.63; p<0.05）和重大并发症发生率（1.8% vs. 3.1%; OR=0.59; 95% CI，0.37-0.95; p<0.05）显著改善。手术参数，如手术持续时间[平均差异（MD）=-28.35; 95% CI，-39.54至-17.16; p<0.05]，消融时间（MD=-3.8; 95% CI，-6.6至-1.0; p<0.05），透视持续时间（MD=-8.18; 95% CI，-14.11至-2.24; p<0.05），辐射剂量（标准MD=-0.75; 95% CI，-1.32至-0.18; p<0.05）显著降低。在12个月的随访期间，与NCF传感导管相比，CF传感导管消融AF可降低重大并发症的发生率，并产生更好的结局。
Contact force (CF) monitoring can be useful in accomplishing circumferential pulmonary vein (PV) isolation for atrial fibrillation (AF). This meta-analysis aimed to assess the efficacy and safety of a CF-sensing catheter in treating AF. Randomized controlled trials or non-randomized observational studies comparing AF ablation using CF-sensing or standard non-CF (NCF)-sensing catheters were identified from PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure (January 1, 1998–2016). A total of 19 studies were included. The primary efficacy endpoint was AF recurrence within 12 months, which significantly improved using CF-sensing catheters compared with using NCF-sensing catheters [31.1% vs. 40.5%; risk ratio (RR)=0.82; 95% confidence interval (CI), 0.73–0.93; p<0.05]. Further, the acute PV reconnection (10.1% vs. 24.2%; RR=0.45; 95% CI, 0.32–0.63; p<0.05) and incidence of major complications (1.8% vs. 3.1%; OR=0.59; 95% CI, 0.37–0.95; p<0.05) significantly improved using CF-sensing catheters compared with using NCF-sensing catheters. Procedure parameters such as procedure duration [mean difference (MD)=-28.35; 95% CI, -39.54 to -17.16; p<0.05], ablation time (MD=-3.8; 95% CI, -6.6 to -1.0; p<0.05), fluoroscopy duration (MD=-8.18; 95% CI, -14.11 to -2.24; p<0.05), and radiation dose (standard MD=-0.75; 95% CI, -1.32 to -0.18; p<0.05] significantly reduced using CF-sensing catheters. CF-sensing catheter ablation of AF can reduce the incidence of major complications and generate better outcomes compared with NCF-sensing catheters during the 12-month follow-up period.