Li Ka H C, Dong Mei, Gong Mengqi, Bazoukis George, Lakhani Ishan, Ting Yan Y, Wong Sunny H, Li Guangping, Wu William K K, Vassiliou Vassilios S, Wong Martin C S, Letsas Konstantinos, Du Yimei, Laxton Victoria, Yan Bryan P, Chan Yat S, Xia Yunlong, Liu Tong, Tse Gary
Faculty of Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
Front Physiol. 2018 May 22;9:544. doi: 10.3389/fphys.2018.00544. eCollection 2018.
Atrial fibrillation is a common abnormal cardiac rhythm caused by disorganized electrical impulses. AF which is refractory to antiarrhythmic management is often treated with catheter ablation. Recently a novel ablation system (nMARQ) was introduced for PV isolation. However, there has not been a systematic review of its efficacy or safety compared to traditional ablation techniques. Therefore, we conducted this meta-analysis on the nMARQ ablation system. PubMed and EMBASE were searched up until 1st of September 2017 for articles on nMARQ. A total of 136 studies were found, and after screening, 12 studies were included in this meta-analysis. Our meta-analysis shows that the use of nMARQ was associated with higher odds of AF non-recurrence ( = 1123, odds ratio = 6.79, 95% confidence interval 4.01-11.50; < 0.05; I took a value of 83%). Moreover, the recurrence rate of AF using nMARQ was not significantly different from that of traditional ablation procedures ( = 158 vs. 196; = 0.97, 95% confidence interval:0.59-1.61). No significant difference in complication rates was observed between these groups (RR: 0.86; 95% CI: 0.37-1.99; > 0.05). There were four reported mortalities in the nMARQ group compared to none in the conventional ablation group (relative risk: 1.58; 95% CI: 0.09-29.24; > 0.05). AF recurrence rates are comparable between nMARQ and conventional ablation techniques. Although general complication rates are similar for both groups, the higher mortality with nMARQ suggests that conventional techniques should be used for resistant AF until improved safety profiles of nMARQ can be demonstrated.
心房颤动是一种由紊乱的电冲动引起的常见心律失常。对抗心律失常治疗无效的房颤通常采用导管消融治疗。最近，一种新型消融系统（nMARQ）被引入用于肺静脉隔离。然而，与传统消融技术相比，尚未对其疗效或安全性进行系统评价。因此，我们对nMARQ消融系统进行了这项荟萃分析。检索了截至2017年9月1日的PubMed和EMBASE数据库中关于nMARQ的文章。共找到136项研究，经过筛选，12项研究纳入了这项荟萃分析。我们的荟萃分析表明，使用nMARQ与房颤无复发的较高几率相关（n = 1123，比值比 = 6.79，95%置信区间4.01 - 11.50；P < 0.05；I²值为83%）。此外，使用nMARQ的房颤复发率与传统消融手术的复发率无显著差异（n = 158 vs. 196；P = 0.97，95%置信区间：0.59 - 1.61）。这些组之间并发症发生率无显著差异（RR：0.86；95% CI：0.37 - 1.99；P > 0.05）。nMARQ组报告有4例死亡，而传统消融组无死亡报告（相对风险：1.58；95% CI：0.09 - 29.24；P > 0.05）。nMARQ和传统消融技术之间的房颤复发率相当。虽然两组的总体并发症发生率相似，但nMARQ较高的死亡率表明，在nMARQ的安全性得到改善之前，对于难治性房颤应采用传统技术。
