Atrial Fibrillation Recurrence and Peri-Procedural Complication Rates in nMARQ vs. Conventional Ablation Techniques: A Systematic Review and Meta-Analysis

Abstract

Background and Objectives: Atrial fibrillation is a common abnormal cardiac rhythm caused by disorganized electrical impulses. AF which is refractory to antiarrhythmic management is often treated with catheter ablation. Recently a novel ablation system (nMARQ) was introduced for PV isolation. However, there has not been a systematic review of its efficacy or safety compared to traditional ablation techniques. Therefore, we conducted this meta-analysis on the nMARQ ablation system.Methods: PubMed and EMBASE were searched up until 1st of September 2017 for articles on nMARQ. A total of 136 studies were found, and after screening, 12 studies were included in this meta-analysis.Results: Our meta-analysis shows that the use of nMARQ was associated with higher odds of AF non-recurrence (n = 1123, odds ratio = 6.79, 95% confidence interval 4.01–11.50; P < 0.05; I2 took a value of 83%). Moreover, the recurrence rate of AF using nMARQ was not significantly different from that of traditional ablation procedures (n = 158 vs. 196; OR = 0.97, 95% confidence interval:0.59–1.61). No significant difference in complication rates was observed between these groups (RR: 0.86; 95% CI: 0.37–1.99; P > 0.05). There were four reported mortalities in the nMARQ group compared to none in the conventional ablation group (relative risk: 1.58; 95% CI: 0.09–29.24; P > 0.05).Conclusions: AF recurrence rates are comparable between nMARQ and conventional ablation techniques. Although general complication rates are similar for both groups, the higher mortality with nMARQ suggests that conventional techniques should be used for resistant AF until improved safety profiles of nMARQ can be demonstrated.

Pathogenesis of Atrial Fibrillation in Patients with Diabetes Mellitus: Impact on Ablation and Disease Recurrence

“…Catheter ablation has already been established as one of the effective therapies for patients with AF to restore sinus rhythm. [66][67][68] According to the research of 521 centres from 42 countries in four continents, the efficacy of catheter ablation in the treatment of patients with either paroxysmal, persistent or long-lasting AF was about 80%, and approximately 70% of patients were not required to take antiarrhythmic drug therapy (ADT) during follow-up. 69 Compared with ADT, catheter ablation has demonstrated more significant clinical benefits in patients with DM.…”

Anaesthesia use in catheter ablation for atrial fibrillation: a systematic review and meta-analysis of observational studies

“…Atrial fibrillation (AF), the most common arrhythmia encountered in clinical practice, affects around 1% of the general population 1 and is associated with a number of life-threatening diseases including stroke, systemic embolism and heart failure. [2][3][4][5] Pharmacological therapy such as antiarrhythmic drugs and anticoagulants has been used to maintain sinus rhythm and prevent stroke, respectively. However, these therapies demonstrate low successful rates for reducing AF recurrence and are associated with adverse effects such as bleeding.…”