Meretsky Christopher R, Patel Vaishvik K, Mahmoodi Arshia, Schiuma Anthony T
Surgery, St. George's University School of Medicine, Great River, USA.
Medicine, St. George's University, West Indies, GRD.
Cureus. 2024 Apr 30;16(4):e59407. doi: 10.7759/cureus.59407. eCollection 2024 Apr.
Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia globally. AF is associated with different consequences, such as peripheral vascular embolism, stroke, dementia, heart failure, and death. Catheter ablation (CA) has become a reliable therapeutic option for symptomatic AF. Utilizing mapping systems in conducting cryoablation is supposed to improve pulmonary vein isolation (PVI) durability and overall treatment success rate. We performed a review of relevant articles. We formulated a search strategy as follows: (atrial fibrillation AND ("cryoballoon ablation" OR cryoablation) AND (KODEX-EPD AND KODEX OR mapping). Data were collected from Web of Science, PubMed, Cochrane Library, and SCOPUS databases. We assessed the efficacy, procedural characteristics, and safety of cryoablation using the KODEX-EPD mapping system versus conventional cryoablation. We demonstrated the superiority of cryoablation guided by the KODEX-EPD system as it was associated with a significantly lower recurrence rate after the procedure (RR = 0.61, P = 0.03). Furthermore, it allowed a significant reduction in the volume of contrast medium used during the procedure (MD = -20.46, P = 0.04) when compared to the conventional cryoablation. We found no significant difference between both procedures in terms of successful cryoballoon-based PVI (P = 1.00), procedural duration (P = 0.95), procedural complications (P = 0.607), fluoroscopic time (P = 0.36), and fluoroscopic dose (P = 0.16). The use of the novel KODEX-EPD mapping system in the cryoablation procedure was associated with a significant reduction of the volume of contrast medium use and the recurrence rate compared with the conventional cryoablation while preserving similar efficacy, safety profile, and procedure time.
心房颤动（AF）是全球最常见的心律失常。AF与不同的后果相关，如外周血管栓塞、中风、痴呆、心力衰竭和死亡。导管消融（CA）已成为有症状AF的可靠治疗选择。在进行冷冻消融时使用标测系统有望提高肺静脉隔离（PVI）的持久性和总体治疗成功率。我们对相关文章进行了综述。我们制定了如下检索策略：（心房颤动 AND（“冷冻球囊消融”或冷冻消融）AND（KODEX-EPD AND KODEX 或标测））。数据从科学网、PubMed、考科蓝图书馆和SCOPUS数据库收集。我们评估了使用KODEX-EPD标测系统的冷冻消融与传统冷冻消融的疗效、操作特征和安全性。我们证明了KODEX-EPD系统引导的冷冻消融的优越性，因为它与术后显著更低的复发率相关（RR = 0.61，P = 0.03）。此外，与传统冷冻消融相比，它在操作过程中允许显著减少造影剂的使用量（MD = -20.46，P = 0.04）。我们发现两种操作在基于冷冻球囊的PVI成功率（P = 1.00）、操作持续时间（P = 0.95）、操作并发症（P = 0.607）、透视时间（P = 0.36）和透视剂量（P = 0.16）方面没有显著差异。与传统冷冻消融相比，在冷冻消融过程中使用新型KODEX-EPD标测系统与造影剂使用量和复发率的显著降低相关，同时保持相似的疗效、安全性和操作时间。
