Comparison of the efficacy and safety of pulmonary vein isolation using cryoballoon versus radiofrequency ablation for paroxysmal atrial fibrillation: An updated meta-analysis

• 来源期刊: 岭南心血管病杂志（英文版）
• 关键词: paroxysmal atrial fibrillation cryoballoon catheter ablation pulmonary vein isolation meta-analysis
• 年，卷（期）: 2017,（1）
• 页码范围: 62-72
• 页数: 11页
• 语种: 英文

摘要

Background Radiofrequency catheter ablation (RFCA) and cryoballoon ablation (CBA) are the two common ablation technologies used for the treatment of paroxysmal atrial fibrillation (PAF).However,there is no consensus on which ablation method is the optimal choice.Methods We searched PubMed,EMBASE,Cochrane Library,Web of Knowledge and clinical trials.gov for clinically controlled trials (published up to January 11,2017).All included studies included fulfilled our previously defined criteria.The primary clinical outcome was the proportion of participants free from atrial fibrillation at 12-months follow-up.;The secondary clinical outcomes were as the procedure time,fluoroscopy time,and total complications.Results We identified 573 studies,seven randomized controlled trials (RCTs) and 11 non-RCTs were included in this analysis (n=4982 participants).Compared with RFCA,CBA had similar proportion of participants free from PAF at 12-months follow-up (70.8％ vs.69％;relative risk [RR]:1.01;95％ CI:0.97 to 1.05).Additionally,procedure time (149.61 vs.174.73rmin;weighted mean difference WMD:25.55;95％ CI:44.69 to 6.41) was shorter in the CBA group,but the fluoroscopy time (34.52 vs.38.59 min;WMD:2.08;95％ CI:5.86 to 1.71) did not have any significant difference.Total complication was not significantly different in both groups (RR:1.22;95％ CI:0.74 to 2.02).Conclusions CBA is similar to RFCA with respect to clinical efficacy for PAF during the follow-up period of 12 months,and with no increased overall safety risk in the cryoballoon group CBA.