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Erschienen in: Journal of Interventional Cardiac Electrophysiology 1/2021

11.10.2020 | Reviews

Second-generation cryoballoon vs. contact-force sensing radiofrequency catheter ablation in atrial fibrillation: a meta-analysis of randomized controlled trials

verfasst von: Yang Wang, Wei Wang, Jianming Yao, Lianghua Chen, Shaolei Yi

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 1/2021

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Abstract

Objectives

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.

Methods

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.

Results

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; I2 = 48%). There were no statistical differences in acute PVI (P = 0.92; I2 = 0%) and serious complications (P = 0.87; I2 = 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; I2 = 59%).

Conclusion

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.
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Literatur
1.
Zurück zum Zitat Roy D. Rationale and design of a study assessing treatment strategies of atrial fibrillation in patients with heart failure: the Atrial Fibrillation and Congestive Heart Failure (AF-CHF) trial. Am Heart J. 2002;144(4):597–607.CrossRef Roy D. Rationale and design of a study assessing treatment strategies of atrial fibrillation in patients with heart failure: the Atrial Fibrillation and Congestive Heart Failure (AF-CHF) trial. Am Heart J. 2002;144(4):597–607.CrossRef
3.
Zurück zum Zitat Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace. 2012;14(4):528–606. https://doi.org/10.1093/europace/eus027. Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace. 2012;14(4):528–606. https://​doi.​org/​10.​1093/​europace/​eus027.
4.
Zurück zum Zitat Hakalahti A, Biancari F, Nielsen JC, Raatikainen MJ. Radiofrequency ablation vs. antiarrhythmic drug therapy as first line treatment of symptomatic atrial fibrillation: systematic review and meta-analysis. Europace. 2015;17(3):370–8. https://doi.org/10.1093/europace/euu376. Hakalahti A, Biancari F, Nielsen JC, Raatikainen MJ. Radiofrequency ablation vs. antiarrhythmic drug therapy as first line treatment of symptomatic atrial fibrillation: systematic review and meta-analysis. Europace. 2015;17(3):370–8. https://​doi.​org/​10.​1093/​europace/​euu376.
7.
Zurück zum Zitat Zhou X, Lv W, Zhang W, Ye Y, Li Y, Zhou Q, et al. Comparative efficacy and safety of contact force-sensing catheter and second-generation cryoballoon ablation for atrial fibrillation: a meta-analysis. Braz J Med Biol Res. 2017;50(9):e6409. https://doi.org/10.1590/1414-431X20176409. Zhou X, Lv W, Zhang W, Ye Y, Li Y, Zhou Q, et al. Comparative efficacy and safety of contact force-sensing catheter and second-generation cryoballoon ablation for atrial fibrillation: a meta-analysis. Braz J Med Biol Res. 2017;50(9):e6409. https://​doi.​org/​10.​1590/​1414-431X20176409.
12.
Zurück zum Zitat Buist TJ, Adiyaman A, Smit JJJ, Ramdat Misier AR, Elvan A. Arrhythmia-free survival and pulmonary vein reconnection patterns after second-generation cryoballoon and contact-force radiofrequency pulmonary vein isolation. Clin Res Cardiol. 2018;107(6):498–506. https://doi.org/10.1007/s00392-018-1211-9. Buist TJ, Adiyaman A, Smit JJJ, Ramdat Misier AR, Elvan A. Arrhythmia-free survival and pulmonary vein reconnection patterns after second-generation cryoballoon and contact-force radiofrequency pulmonary vein isolation. Clin Res Cardiol. 2018;107(6):498–506. https://​doi.​org/​10.​1007/​s00392-018-1211-9.
13.
Zurück zum Zitat Giannopoulos G, Kossyvakis C, Vrachatis D, Aggeli C, Tsitsinakis G, Letsas K, et al. Effect of cryoballoon and radiofrequency ablation for pulmonary vein isolation on left atrial function in patients with nonvalvular paroxysmal atrial fibrillation: a prospective randomized study (Cryo-LAEF study). J Cardiovasc Electrophysiol. 2019;30(7):991–8. https://doi.org/10.1111/jce.13933. Giannopoulos G, Kossyvakis C, Vrachatis D, Aggeli C, Tsitsinakis G, Letsas K, et al. Effect of cryoballoon and radiofrequency ablation for pulmonary vein isolation on left atrial function in patients with nonvalvular paroxysmal atrial fibrillation: a prospective randomized study (Cryo-LAEF study). J Cardiovasc Electrophysiol. 2019;30(7):991–8. https://​doi.​org/​10.​1111/​jce.​13933.
14.
Zurück zum Zitat Squara F, Zhao A, Marijon E, Latcu DG, Providencia R, Di Giovanni G, et al. Comparison between radiofrequency with contact force-sensing and second-generation cryoballoon for paroxysmal atrial fibrillation catheter ablation: a multicentre European evaluation. Europace. 2015;17(5):718–24. https://doi.org/10.1093/europace/euv060. Squara F, Zhao A, Marijon E, Latcu DG, Providencia R, Di Giovanni G, et al. Comparison between radiofrequency with contact force-sensing and second-generation cryoballoon for paroxysmal atrial fibrillation catheter ablation: a multicentre European evaluation. Europace. 2015;17(5):718–24. https://​doi.​org/​10.​1093/​europace/​euv060.
18.
Zurück zum Zitat Gunawardene MA, Hoffmann BA, Schaeffer B, Chung DU, Moser J, Akbulak RO, et al. Influence of energy source on early atrial fibrillation recurrences: a comparison of cryoballoon vs. radiofrequency current energy ablation with the endpoint of unexcitability in pulmonary vein isolation. Europace. 2018;20(1):43–9. https://doi.org/10.1093/europace/euw307. Gunawardene MA, Hoffmann BA, Schaeffer B, Chung DU, Moser J, Akbulak RO, et al. Influence of energy source on early atrial fibrillation recurrences: a comparison of cryoballoon vs. radiofrequency current energy ablation with the endpoint of unexcitability in pulmonary vein isolation. Europace. 2018;20(1):43–9. https://​doi.​org/​10.​1093/​europace/​euw307.
19.
Zurück zum Zitat Watanabe R, Sairaku A, Yoshida Y, Nanasato M, Kamiya H, Suzuki H, et al. Head-to-head comparison of acute and chronic pulmonary vein stenosis for cryoballoon versus radiofrequency ablation. Pacing Clin Electrophysiol : PACE. 2018;41(4):376–82. https://doi.org/10.1111/pace.13293. Watanabe R, Sairaku A, Yoshida Y, Nanasato M, Kamiya H, Suzuki H, et al. Head-to-head comparison of acute and chronic pulmonary vein stenosis for cryoballoon versus radiofrequency ablation. Pacing Clin Electrophysiol : PACE. 2018;41(4):376–82. https://​doi.​org/​10.​1111/​pace.​13293.
20.
22.
Zurück zum Zitat Kajiyama T, Miyazaki S, Matsuda J, Watanabe T, Niida T, Takagi T, et al. Anatomic parameters predicting procedural difficulty and balloon temperature predicting successful applications in individual pulmonary veins during 28-mm second-generation cryoballoon ablation. JACC Clin Electrophysiol. 2017;3(6):580–8. https://doi.org/10.1016/j.jacep.2017.01.004. Kajiyama T, Miyazaki S, Matsuda J, Watanabe T, Niida T, Takagi T, et al. Anatomic parameters predicting procedural difficulty and balloon temperature predicting successful applications in individual pulmonary veins during 28-mm second-generation cryoballoon ablation. JACC Clin Electrophysiol. 2017;3(6):580–8. https://​doi.​org/​10.​1016/​j.​jacep.​2017.​01.​004.
24.
Zurück zum Zitat Yokokawa M, Chugh A, Latchamsetty R, Ghanbari H, Crawford T, Jongnarangsin K, et al. Ablation of paroxysmal atrial fibrillation using a second-generation cryoballoon catheter or contact-force sensing radiofrequency ablation catheter: a comparison of costs and long-term clinical outcomes. J Cardiovasc Electrophysiol. 2018;29(2):284–90. https://doi.org/10.1111/jce.13378. Yokokawa M, Chugh A, Latchamsetty R, Ghanbari H, Crawford T, Jongnarangsin K, et al. Ablation of paroxysmal atrial fibrillation using a second-generation cryoballoon catheter or contact-force sensing radiofrequency ablation catheter: a comparison of costs and long-term clinical outcomes. J Cardiovasc Electrophysiol. 2018;29(2):284–90. https://​doi.​org/​10.​1111/​jce.​13378.
25.
26.
Zurück zum Zitat Jourda F, Providencia R, Marijon E, Bouzeman A, Hireche H, Khoueiry Z, et al. Contact-force guided radiofrequency vs. second-generation balloon cryotherapy for pulmonary vein isolation in patients with paroxysmal atrial fibrillation-a prospective evaluation. Europace. 2015;17(2):225–31. https://doi.org/10.1093/europace/euu215. Jourda F, Providencia R, Marijon E, Bouzeman A, Hireche H, Khoueiry Z, et al. Contact-force guided radiofrequency vs. second-generation balloon cryotherapy for pulmonary vein isolation in patients with paroxysmal atrial fibrillation-a prospective evaluation. Europace. 2015;17(2):225–31. https://​doi.​org/​10.​1093/​europace/​euu215.
29.
Zurück zum Zitat Nct. Changes in cardiac autonomic nervous system following atrial fibrillation ablation. https://clinicaltrialsgov/show/NCT03811639 2019. Nct. Changes in cardiac autonomic nervous system following atrial fibrillation ablation. https://​clinicaltrialsgo​v/​show/​NCT03811639 2019.
Metadaten
Titel
Second-generation cryoballoon vs. contact-force sensing radiofrequency catheter ablation in atrial fibrillation: a meta-analysis of randomized controlled trials
verfasst von
Yang Wang
Wei Wang
Jianming Yao
Lianghua Chen
Shaolei Yi
Publikationsdatum
11.10.2020
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 1/2021
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-020-00893-w

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