Dataset Information

Comparison of high-power short-duration and low-power long-duration radiofrequency ablation for treating atrial fibrillation: Systematic review and meta-analysis.

ABSTRACT:

Background

High power shorter duration (HPSD) ablation seen to increase efficacy and safety treating of atrial fibrillation (AF); however, comparative data between HPSD and low power longer duration (LPLD) ablation are limited.

Hypothesis

We thought that HPSD might bring more clinical benefits. The aim of this meta-analysis was to evaluate the clinical benefits of HPSD in patients with AF.

Methods

The Medline, PubMed, Embase, and the Cochrane Library databases were searched for studies comparing HPSD and LPLD ablation.

Results

Ten trials with 2467 patients were included in the analysis. Pooled analyses demonstrated that HPSD showed a benefit of first-pass pulmonary vein isolation (PVI) (risk ratio [RR]: 1.20; 95% confidence interval [CI]: 1.10-1.31, P < .001) and recurrence of atrial arrhythmias (RR: 0.73; 95% CI: 0.58-0.91, P = .005). Additionally, HPSD could reduce procedural time (weighted mean difference [WMD]: -42.93; 95% CI, -58.10 to -27.75, P < .001), ablation time (WMD: -21.01; 95% CI: -24.55 to -17.47, P < .001), and fluoroscopy time (WMD: -4.11; 95% CI: -6.78 to -1.45, P < .001). Moreover, major complications and esophageal thermal injury (ETI) were similar between two groups (RR: 0.75; 95% CI: 0.44-1.30, P = .31) and (RR: 0.57; 95% CI: 0.21-1.51, P = .26).

Conclusions

HPSD was safe and efficient for treating AF. Compared with LPLD, HPSD was associated with advantages of procedural features, higher first-pass PVI and reducing recurrence of atrial arrhythmias. Moreover, major complications and ETI were similar between two groups.

SUBMITTER: Chen CF

PROVIDER: S-EPMC7724222 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Comparison of high-power short-duration and low-power long-duration radiofrequency ablation for treating atrial fibrillation: Systematic review and meta-analysis.

Chen Chao-Feng CF Wu Jing J Jin Chao-Lun CL Liu Mei-Jun MJ Xu Yi-Zhou YZ

Clinical cardiology 20201027 12

<h4>Background</h4>High power shorter duration (HPSD) ablation seen to increase efficacy and safety treating of atrial fibrillation (AF); however, comparative data between HPSD and low power longer duration (LPLD) ablation are limited.<h4>Hypothesis</h4>We thought that HPSD might bring more clinical benefits. The aim of this meta-analysis was to evaluate the clinical benefits of HPSD in patients with AF.<h4>Methods</h4>The Medline, PubMed, Embase, and the Cochrane Library databases were searched ...[more]

PMID: 33107625

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Project description:High-power short-duration (HPSD) setting during radiofrequency ablation has become an attempt to improve atrial fibrillation (AF) treatment outcomes. This study ought to compare the efficacy, safety, and effectiveness between HPSD and conventional settings. PubMed, Embase, and Cochrane Library were searched. Studies that compared HPSD and conventional radiofrequency ablation settings in AF patients were included while studies performed additional ablations on nonpulmonary vein targets without clear recording were excluded. Data were pooled with random-effect model. Efficacy endpoints include first-pass pulmonary vein isolation (PVI), acute pulmonary vein (PV) reconnection, free from AF, and free from atrial tachycardia (AT) during follow-up. Safety endpoints include esophagus injury rate and major complication rate. Effectiveness endpoints include complete PVI rate, total procedure time, PVI time, and PVI radiofrequency ablation (PVI RF) time. We included 22 studies with 3867 atrial fibrillation patients in total (2393 patients received HPSD radiofrequency ablation). Perioperatively, the HPSD group showed a higher first-pass PVI rate (risk ratio, RR = 1.10, P = 0.0001) and less acute PV reconnection rate (RR = 0.56, P = 0.0004) than the conventional group. During follow-up, free from AF (RR = 1.11, P = 0.16) or AT (RR = 1.06, P = 0.24) rate did not differ between HPSD and conventional groups 6-month postsurgery. However, the HPSD group showed both higher free from AF (RR = 1.17, P = 0.0003) and AT (RR = 1.11, P < 0.0001) rate than the conventional group 12-month postsurgery. The esophagus injury (RR = 0.99, P = 0.98) and major complications (RR = 0.76, P = 0.70) rates did not differ between the two groups. The HPSD group took shorter total procedure time (MD = -33.71 95% CI: -43.10 to -24.33, P < 0.00001), PVI time (MD = -21.60 95% CI: -25.00 to -18.21, P < 0.00001), and PVI RF time (MD = -13.72, 95% CI: -14.45 to -13.00, P < 0.00001) than conventional groups while complete procedure rate did not differ between two groups (RR = 1.00, P = 0.93). HPSD setting during AF radiofrequency ablation has better effectiveness, efficacy, and similar safety compared with the conventional setting.

Dataset Information

Comparison of high-power short-duration and low-power long-duration radiofrequency ablation for treating atrial fibrillation: Systematic review and meta-analysis.

Background

Hypothesis

Methods

Results

Conclusions

Publications

Comparison of high-power short-duration and low-power long-duration radiofrequency ablation for treating atrial fibrillation: Systematic review and meta-analysis.

Similar Datasets

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