Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China.
J Interv Cardiol. 2022 Aug 16;2022:6013474. doi: 10.1155/2022/6013474. eCollection 2022.
We aimed to evaluate the effectiveness and safety between high-power short-duration (HPSD) radiofrequency ablation (RFA) and conventional RFA in patients with atrial fibrillation (AF).
Studies comparing HPSD and traditional applications in patients undergoing initial catheter ablation for atrial fibrillation from inception through December 2021 were searched on Pubmed, Medline, Cochrane, and Clinicaltrials.gov.
The meta-analysis included seventeen studies with a total of 4934 patients. HPSD group decreased procedure duration (mean difference (MD) -38.28 min, < 0.001), RF duration (MD -20.51 min, < 0.001), fluoroscopy duration (MD -5.19 min, < 0.001), and acute pulmonary vein reconnection (Odds ratio (OR) 0.40, < 0.001), while improving the freedom from atrial arrhythmia at one year (OR 1.48, 95% confidence interval (CI) 1.12-1.94, =0.005) and rates of first-pass isolation (OR 8.92, =0.001). Compared with the conventional group, freedom from atrial arrhythmia at one-year follow-up was higher in the HPSD group without the guidance of AI/LSI (OR 1.66, =0.01) and studies with a power setting of 40-50 W (OR 1.93, =0.002). Nevertheless, the two groups had similar effectiveness with a power setting of 50 W in the HPSD RFA (OR 1.10, =0.52). There was no difference in complications between the two groups (=0.71).
HPSD RFA was associated with shorter procedure duration, higher freedom from atrial arrhythmia, and comparable safety compared to conventional RFA.
评估高功率短时间（HPSD）射频消融（RFA）与传统 RFA 在心房颤动（AF）患者中的有效性和安全性。
通过 Pubmed、Medline、Cochrane 和 Clinicaltrials.gov 检索了从 2021 年 12 月起，比较初始导管消融治疗心房颤动患者中 HPSD 和传统应用的研究。
荟萃分析纳入了 17 项研究，共 4934 例患者。HPSD 组缩短了手术时间（平均差值（MD）-38.28 分钟， < 0.001）、射频时间（MD-20.51 分钟， < 0.001）、透视时间（MD-5.19 分钟， < 0.001）和急性肺静脉再连接（比值比（OR）0.40， < 0.001），同时提高了一年无房性心律失常的发生率（OR 1.48，95%置信区间（CI）1.12-1.94，=0.005）和一次性隔离率（OR 8.92，=0.001）。与常规组相比，在没有人工智能/低强度刺激（AI/LSI）指导和功率设置为 40-50 W 的研究中，HPSD 组一年随访时无房性心律失常的发生率更高（OR 1.66，=0.01）和（OR 1.93，=0.002）。然而，在 HPSD RFA 功率设置为 50 W 时，两组的疗效相似（OR 1.10，=0.52）。两组之间的并发症无差异（=0.71）。
与传统 RFA 相比，HPSD RFA 可缩短手术时间，提高无房性心律失常发生率，且安全性相当。
