Department of Radiation Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Department of Cardiology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.
J Interv Card Electrophysiol. 2021 Jan;60(1):9-19. doi: 10.1007/s10840-020-00893-w. Epub 2020 Oct 11.
It is imperative to understand the influence of second-generation cryoballoon (CB-2) and contact-force sensing radiofrequency ablation (CF-RF) on clinical outcomes in atrial fibrillation (AF). This updated meta-analysis of randomized controlled trials (RCTs) examined the efficacy and safety of CB-2 vs. CF-RF in patients with AF.
RCTs on the use of CB-2 vs. CF-RF in patients with AF were included. The primary outcome was the recurrence of AF, and the key secondary outcomes included serious complications, acute pulmonary vein isolation (PVI), procedure duration, and fluoroscopy time.
A total of 261 articles were identified, and five studies with a total of 845 participants were included in the study. A total of 93% of participants had paroxysmal AF, 7% of participants had persistent AF, and none of participants had permanent AF. There were 499 participants in the CB-2 arm and 346 in the CF-RF arm. AF recurrence was comparable in the CB-2 group (30.3%) and the CF-RF group (29.2%) (OR = 0.93; 95%CI = 0.56-1.54; P = 0.79; I = 48%). There were no statistical differences in acute PVI (P = 0.92; I = 0%) and serious complications (P = 0.87; I = 47%) between the two groups. The procedure duration was shorter in the CB-2 group than in the CF-RF group (MD = - 13.39; 95%CI = - 15.58, - 7.19; P < 0.0001; I = 59%).
Our study demonstrated that CB-2 and CF-RF had comparable recurrences of AF and similar incidences of serious complications in AF patients during the ablation process.
了解第二代冷冻球囊（CB-2）和接触力感应射频消融（CF-RF）对心房颤动（AF）临床结果的影响至关重要。本项针对随机对照试验（RCT）的更新荟萃分析研究了 CB-2 与 CF-RF 在 AF 患者中的疗效和安全性。
纳入了关于 CB-2 与 CF-RF 在 AF 患者中应用的 RCT 研究。主要结局是 AF 的复发，关键次要结局包括严重并发症、急性肺静脉隔离（PVI）、手术时间和透视时间。
共确定了 261 篇文章，其中 5 项研究共 845 名患者纳入本研究。93%的参与者患有阵发性 AF，7%的参与者患有持续性 AF，无永久性 AF 患者。CB-2 组有 499 名参与者，CF-RF 组有 346 名参与者。CB-2 组的 AF 复发率（30.3%）与 CF-RF 组（29.2%）相似（OR=0.93；95%CI=0.56-1.54；P=0.79；I=48%）。两组之间急性 PVI（P=0.92；I=0%）和严重并发症（P=0.87；I=47%）发生率无统计学差异。CB-2 组的手术时间短于 CF-RF 组（MD=-13.39；95%CI=-15.58，-7.19；P<0.0001；I=59%）。
本研究表明，在消融过程中，CB-2 和 CF-RF 治疗 AF 患者的 AF 复发率相似，严重并发症发生率也相似。
