Lin Hui, Chen Yi-He, Hou Jian-Wen, Lu Zhao-Yang, Xiang Yin, Li Yi-Gang
Department of Respiratory, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Cardiology, Xinhua Hospital affiliated to the Medical School of Shanghai Jiaotong University, Shanghai, China.
J Cardiovasc Electrophysiol. 2017 Sep;28(9):994-1005. doi: 10.1111/jce.13264. Epub 2017 Jun 23.
CF-sensing catheter emerged as a novel ablation technology and was increasingly used in clinical practice. Nonetheless, available evidence of efficacy and safety comparison between CF-guided RF catheter ablation and non-CF-guided ablation for treatment of AF was still lacking.
Twenty-two eligible studies were included after systematic review through the MEDLINE, Google Scholar, the Cochrane Library and PubMed databases. AF/atrial tachycardia-free survival was markedly improved in CF-guided catheter ablation compared with non-CF-guided ablation at a median 12-month follow-up (RR: 1.12, 95% CI: 1.06-1.19, P = 0.000, fixed). Notably, CF-guided catheter ablation presented a robust survival benefit for treatment of paroxysmal AF (RR: 1.10, 95% CI: 1.03-1.18, P = 0.005, fixed), but not persistent AF (RR: 1.07, 95% CI: 0.89-1.28, P = 0.466, fixed). Moreover, procedure time (WMD: -23.87, 95% CI: -33.83 to -13.91, P = 0.000, random), fluoroscopy time (WMD: -7.78, 95% CI: -13.93 to -1.63, P = 0.013, random) and RF time (WMD: -3.98, 95% CI: -7.78 to -0.17, P = 0.040, random) were significantly reduced in CF-guided catheter ablation. The incidence of procedure-related complications did not differ between these two technologies (RR: 0.83, 95% CI: 0.59 to 1.16, P = 0.271, fixed).
CF-guided RF catheter ablation was associated with a significant AF/atrial tachycardia-free survival benefit compared with non-CF-guided ablation in patients with paroxysmal AF rather than persistent AF. In addition, CF-guided ablation strategy also reduced the procedure time, fluoroscopy time, as well as RF time despite no distinct effect on the alleviation of procedure-related complications.
接触力感知导管作为一种新型消融技术，在临床实践中的应用日益广泛。然而，对于接触力引导下的射频导管消融与非接触力引导下的消融治疗房颤的疗效和安全性比较，仍缺乏现有证据。
通过对MEDLINE、谷歌学术、考克兰图书馆和PubMed数据库进行系统综述，纳入了22项符合条件的研究。在中位12个月的随访中，与非接触力引导下的消融相比，接触力引导下的导管消融显著提高了无房颤/房性心动过速生存率（风险比：1.12，95%置信区间：1.06-1.19，P = 0.000，固定效应模型）。值得注意的是，接触力引导下的导管消融对阵发性房颤的治疗具有显著的生存获益（风险比：1.10，95%置信区间：1.03-1.18，P = 0.005，固定效应模型），但对持续性房颤则不然（风险比：1.07，95%置信区间：0.89-1.28，P = 0.466，固定效应模型）。此外，接触力引导下的导管消融显著缩短了手术时间（加权均数差：-23.87，95%置信区间：-33.83至-13.91，P = 0.000，随机效应模型）、透视时间（加权均数差：-7.78，95%置信区间：-
