Pulsed Field Versus High-Power Short-Duration Radiofrequency Ablation in Atrial Fibrillation: A Meta-Analysis.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Pace-Pacing and Clinical Electrophysiology Pub Date : 2025-04-01 Epub Date: 2025-02-24 DOI:10.1111/pace.15166

Muhammad Hassan Waseem, Zain Ul Abideen, Ayesha Ahmed, Barka Sajid, Ameer Haider Cheema, Noor Ul Huda Ramzan, Amina Tahir, Sania Aimen

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引用次数: 0

Abstract

Background: Atrial fibrillation, which has increased in prevalence by 33% over the past two decades, affects 59 million people worldwide. It is treated using thermal and nonthermal techniques like radiofrequency, cryoballoon, laser, and pulsed-field ablation (PFA). This meta-analysis is the first to compare PFA with high-power short-duration radiofrequency ablation (HPSD-RFA).

Methods: We comprehensively searched PubMed, Cochrane Central, and ScienceDirect from inception to August 2024. In Review Manager 5.4.1, we pooled risk ratios (RRs) and weighted mean difference (WMD) along with 95% confidence intervals for dichotomous and continuous outcomes, respectively, and employed a random effects model. Study quality was assessed via the Newcastle-Ottawa Scale, and funnel plots were used to evaluate the risk of publication bias.

Results: Seven studies with a total of 1538 patients were analyzed in this meta-analysis. PFA was associated with a shorter total procedural time (MD = -36.39 min; 95% CI: [-46.23, -26.55]; p < 0.00001; I² = 90%), left atrial dwell time (MD = -33.22 min; 95% CI: [-53.21, -13.23]; p = 0.001; I² = 93%), and a longer fluoroscopy time compared to the HPSD-RFA (MD = 9.06 min; 95% CI: [6.13, 11.99]; p < 0.00001; I² = 96%). Other outcomes were comparable between the two arms.

Conclusion: PFA outperforms HPSD ablation in terms of procedural efficiency outcomes except for the total fluoroscopy time. Still, both techniques are comparable regarding safety and arrhythmia control outcomes.

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脉冲场与高功率短时间射频消融治疗心房颤动：荟萃分析。

背景：在过去二十年中，房颤的患病率增加了33%，影响了全世界5900万人。治疗方法包括射频、低温球囊、激光和脉冲场消融（PFA）等热和非热技术。这项荟萃分析首次将PFA与高功率短时间射频消融（HPSD-RFA）进行了比较。方法：我们综合检索PubMed、Cochrane Central和ScienceDirect从成立到2024年8月。在Review Manager 5.4.1中，我们将风险比（rr）和加权平均差（WMD）分别与二分类和连续结果的95%置信区间合并，并采用随机效应模型。通过纽卡斯尔-渥太华量表评估研究质量，并使用漏斗图评估发表偏倚风险。结果：本荟萃分析分析了7项研究，共1538例患者。PFA与较短的手术总时间相关(MD = -36.39 min；95% ci: [-46.23, -26.55]；p 2 = 90%)，左房停留时间(MD = -33.22 min；95% ci: [-53.21, -13.23]；P = 0.001；I2 = 93%)，与HPSD-RFA相比，透视时间更长(MD = 9.06 min；95% ci: [6.13, 11.99]；P < 2 = 96%)。两组之间的其他结果具有可比性。结论：除总透视时间外，PFA在手术效率方面优于HPSD消融。尽管如此，两种技术在安全性和心律失常控制结果方面是相当的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pace-Pacing and Clinical Electrophysiology 医学-工程：生物医学

CiteScore

2.70

自引率

5.60%

发文量

209

审稿时长

2-4 weeks

期刊介绍： Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.