Efficacy and safety of high-power short-duration ablation for atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Ahmed Mazen Amin, Ramy Ghaly, Ahmed A Ibrahim, Mohamed Ahmed Ali, Omar Almaadawy, Amr Elzahaby, Mohamed Abuelazm, Basel Abdelazeem, Muhammad Bilal Munir
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引用次数: 0

Abstract

Background: High-power short-duration (HPSD) ablation has emerged as an alternative to conventional standard-power long-duration (SPLD) ablation. We aim to assess the efficacy and safety of HPSD versus SPLD for atrial fibrillation (AF) ablation.

Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL were performed through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI).

Prospero id: CRD42023471797.

Results: We included six RCTs with a total of 694 patients. HPSD was significantly associated with a decreased total procedure time (MD: -22.88 with 95% CI [-36.13, -9.63], P = 0.0007), pulmonary vein isolation (PVI) time (MD: -19.73 with 95% CI [-23.93, -15.53], P < 0.00001), radiofrequency time (MD: -10.53 with 95% CI [-12.87, -8.19], P < 0.00001). However, there was no significant difference between HPSD and SPLD ablation with respect to the fluoroscopy time (MD: -0.69 with 95% CI [-2.00, 0.62], P = 0.30), the incidence of esophageal lesions (RR: 1.15 with 95% CI [0.43, 3.07], P = 0.77), and the incidence of first pass isolation (RR: 0.98 with 95% CI [0.88, 1.08], P = 0.65).

Conclusion: HPSD ablation was significantly associated with decreased total procedure time, PVI time, and radiofrequency time compared with SPLD ablation. On the contrary, SPLD ablation was significantly associated with low maximum temperature.

Abstract Image

高功率短时消融术治疗心房颤动的疗效和安全性:随机对照试验的系统回顾和荟萃分析。
背景:高功率短持续时间(HPSD)消融术已成为传统标准功率长持续时间(SPLD)消融术的替代方案。我们旨在评估心房颤动(房颤)消融术中高功率短持续时间消融术与标准功率长持续时间消融术的疗效和安全性:截至 2023 年 8 月,我们对从 PubMed、WOS、SCOPUS、EMBASE 和 CENTRAL 检索到的随机对照试验 (RCT) 进行了系统综述和荟萃分析。我们使用 RevMan V. 5.4 使用风险比 (RR) 汇集二分法数据,使用平均差 (MD) 和 95% 置信区间 (CI) 汇集连续数据:CRD42023471797.Results:结果:我们纳入了六项研究,共有 694 名患者。HPSD与手术总时间(MD:-22.88,95% CI [-36.13,-9.63],P = 0.0007)、肺静脉隔离(PVI)时间(MD:-19.73,95% CI [-23.93,-15.53],P 结论:HPSD消融与手术总时间明显相关:与 SPLD 消融术相比,HPSD 消融术明显缩短了手术总时间、PVI 时间和射频时间。相反,SPLD消融术与低最高温度明显相关。
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来源期刊
CiteScore
4.30
自引率
11.10%
发文量
320
审稿时长
4-8 weeks
期刊介绍: The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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