Impact of image integration on clinical and procedural outcomes of radiofrequency catheter ablation of atrial fibrillation: A meta‐analysis of randomized controlled trials

Background The purpose of this meta‐analysis was to evaluate the impact of image integration technique on clinical and procedural outcomes in patients undergoing radiofrequency catheter ablation of atrial fibrillation with a three‐dimensional electroanatomic mapping system. Methods Randomized controlled trials were identified through a systematic literature search of PubMed and CENTRAL databases from inception to April 2020. The primary outcome was arrhythmia recurrence during the follow‐up period. The secondary outcomes were the difference in total procedural time and fluoroscopy time. Results Four studies with a total of 749 patients were included. The pooled result showed no statistically significant difference between the groups with respect to arrhythmia recurrence (RR, 0.75; 95% CI, 0.47‐1.21), fluoroscopy time (MD, −6 minutes; 95% CI, −23.4 to 11.3), and total procedural time (MD, 1.1 minutes; 95% CI, −31.8 to 34.1). Conclusion Image integration to guide radiofrequency catheter ablation for patients with atrial fibrillation does not improve clinical and procedural outcomes.
Meta‐analysis of four randomized controlled trials showed that integration of preprocedural CT or MRI images with real‐time electroanatomic maps to guide pulmonary vein isolation does not improve clinical and procedural outcomes.