1. Assessment of High-Power Catheter Ablation in Patients With Atrial Fibrillation: A Meta-Analysis
- Author
-
Yin Xiang, Fangyi Xiao, Yi-He Chen, Hui Lin, Zhouqing Huang, Zhi-Jie Mao, and Yan Pei
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,high-power ablation ,Catheter ablation ,Cochrane Library ,Cardiovascular Medicine ,Pulmonary vein ,Internal medicine ,catheter ablation ,Diseases of the circulatory (Cardiovascular) system ,Medicine ,Sinus rhythm ,atrial fibrillation ,Survival rate ,business.industry ,Atrial fibrillation ,Ablation ,medicine.disease ,ablation lesion ,meta-analysis ,RC666-701 ,Relative risk ,Cardiology ,Systematic Review ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: High-power radiofrequency (RF) catheter ablation was considered as a promising alternative strategy to conventional-power ablation in the treatment of patients with atrial fibrillation (AF). This study sought to compare the efficacy and safety of high-power energy delivery to that of conventional-power setting in AF catheter ablation.Methods: We performed a systematic review of relevant literature in Pubmed, Embase, Cochrane library, and Google Scholar database. Sixteen eligible studies totaling 3,307 patients (1,929 for high-power ablation; 1,378 for conventional-power ablation) met inclusion criteria.Results: During a median 12 month follow-up, high-power ablation showed a significantly higher AF/atrial tachycardia-free survival rate in comparison with conventional-power ablation (risk ratio [RR] 1.09, 95% CI 1.02 to 1.15, p = 0.008). Notably, a high-power strategy convincingly decreased the procedure time (weighted mean difference [WMD] −46.11 min, 95% CI −59.15 to −33.07, p < 0.001) and RF ablation time (WMD −19.19 min, 95% CI −24.47 to −13.90, p < 0.001), along with reduced fluoroscopy time (WMD −7.82 min, 95% CI −15.13 to −0.68, p = 0.036). In addition, there was no perceptible difference in the potential risk of procedure-related complications between these two approaches (RR 0.81, 95% CI 0.48 to 1.37, p = 0.428).Conclusions: High-power RF catheter ablation was associated with an improvement in long-term sinus rhythm maintenance for treatment of AF, without exacerbating the risk of adverse events during the procedure. Impressively, high-power pulmonary vein isolation had the potential to shorten the application duration and minimize fluoroscopic exposure.
- Published
- 2021