Comparative efficacy and safety of contact force-sensing catheter and second-generation cryoballoon ablation for atrial fibrillation: a meta-analysis

Abstract

This meta-analysis compared the efficacy and safety of the contact force (CF)-sensing catheter and second-generation cryoballoon (CB) ablation for treating atrial fibrillation (AF). Six controlled clinical trials comparing ablation for AF using a CF-sensing catheter or second-generation CB were identified from PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure. The procedure duration was significantly lower in the CB group compared with that in the CF group [mean difference (MD)=29.4; 95%CI=17.84–40.96; P=0.01], whereas there was no difference between the groups for fluoroscopy duration (MD=0.59; 95%CI=–4.48–5.66; P=0.82). Moreover, there was no difference in the incidence of non-lethal complications (embolic event, tamponade, femoral/subclavian hematoma, arteriovenous fistula, pulmonary vein stenosis, phrenic nerve palsy, and esophageal injury) between the CB and the CF groups (8.38 vs 5.35%; RR=0.66; 95%CI=0.37–1.17; P=0.15). Transient phrenic nerve palsy occurred in 17 of 326 patients (5.2%) of the CB group vs none in the CF group (RR=0.12; 95%CI=0.03–0.43; P=0.001). A comparable proportion of patients in CF and CB groups suffered from AF recurrence during the 12-month follow-up after a single ablation procedure [risk ratio (RR)=1.03; 95%CI=0.78–1.35; P=0.84]. AF ablation using CF-sensing catheters and second-generation CB showed comparable fluoroscopy duration and efficacy (during a 12-month follow-up), with shorter procedure duration and different complications in the CB group.

Atrial fibrillation ablation using cryoballoon technology: Recent advances and practical techniques

“…Recent meta‐analysis including 7,195 patients from 16 studies showed that as compared with RF ablation, cryoablation presented a comparable mid‐ and long‐term arrhythmia‐free survival and similar procedure‐related events . These results were also consistent when cryoballoon was compared with contact force RF catheter …”

Trends over the recent 6 years in ablation modalities and strategies, post‐ablation medication, and clinical outcomes of atrial fibrillation ablation

“…The post‐ablation use of AADs might be a confounder; however, those were not statistically associated with AF/AT recurrence. Several meta‐analysis reports have shown a contact force‐guided PVI and balloon‐based ablation significantly improved the AF freedom rate 35,36 . The PAF patients in this study underwent a contact force‐guided PVI or balloon ablation.…”

“…Several meta-analysis reports have shown a contact force-guided PVI and balloon-based ablation significantly improved the AF freedom rate. 35,36 The PAF patients in this study underwent a contact force-guided PVI or balloon ablation. Therefore, our results might support a high success rate with PVI methods achieving a durable PVI in PAF patients even when extending the ablation indication to a remodeled LA.…”