Comparative efficacy and safety of catheter ablation interventions for atrial fibrillation: comprehensive network meta-analysis of randomized controlled trials

Zhou, Xinbin; Dai, Jin; Xu, Xiaoming; Lian, Miaojun; Lou, Yang; Lv, Zhengtian; Wang, Zhijun; Mao, Wei

doi:10.1007/s10840-020-00878-9

Cited by 4 publications

(3 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A median of 29 lesions [IQR 26-34] were applied in a median ablation time of 16 min [IQR 13-23] per PV (Table 2). Median energy delivery was 10 watts per lesion [IQR 9-10] during a median energy delivery time of 20 s [IQR [19][20].…”

Section: Procedural Datamentioning

confidence: 99%

“…The visually guided laser balloon (VGLB) is an ablation system designed for PVI-only ablation that allows real-time visualization of target tissue through an endoscopic camera, uses a compliant balloon to optimize tissue contact in different PV anatomies and a near-infrared laser with titratable energy, which is rotated circumferentially to create overlapping ablation lesions. Previous studies report high rates of acute PVI and durability at midterm follow-up [9][10][11][12][13][14][15][16], with success rates comparable to conventional radiofrequency ablation (RFA) and cryoballoon ablation [13,[16][17][18][19][20]. Reported long-term results are promising [13,21], but available evidence is limited.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary vein isolation by visually guided laser balloon ablation: single-center 5-year follow-up results

Koopman

Bekelaar

Schurmans

et al. 2023

J Interv Card Electrophysiol

View full text Add to dashboard Cite

Background Visually guided laser balloon (VGLB) ablation is a balloon-based treatment for atrial fibrillation (AF) that uses a titratable laser energy source to perform pulmonary vein isolation (PVI), allowing for real-time visualization of target tissue and ablation lesions through an endoscopic camera. Few long-term data on this technique are currently available. This report presents acute efficacy, procedural data, complication rates, and long-term AF-free survival up to 5 years post-ablation. Methods In this single-center, retrospective, observational report, 152 patients (72.4% male, mean age 60.6 ± 9.7 years, 62.5% paroxysmal AF, 598 pulmonary veins in total) treated with the first-generation VGLB system between 2014 and 2016 were included for analysis. AF ablation consisted of PVI only. Results Acute PVI was achieved in 98.2% of veins, with first-pass isolation in 92.5%. Procedure duration of 129 min [IQR 113–150], fluoroscopy time of 15 min [IQR 11–20], and dose area product of 5016 mGy·cm2 [IQR 3603–8711] were recorded. During a median follow-up of 51 months [IQR 45–57], 74.3% of patients remained free of AF (78.8% for paroxysmal and 65.3% for persistent AF, p = 0.108). Freedom of AF at 1, 2, 3, and 4 years follow-up was 88.2%, 82.2%, 78.9%, and 74.8%, respectively. PV reconnections were identified in only 46.9% of redo procedures. The median number of PV reconnections during redo procedures was 0 [IQR 0–2]. Anti-arrhythmic drug use was significantly reduced after ablation (p < 0.001). The most commonly reported complications were minor vascular complications (4.6%) and transient phrenic nerve paralysis (3.3%). Conclusions First-generation VGLB ablation demonstrated high acute isolation rates, reasonable procedure times and low complication rates. Long-term freedom from AF was 78.8% for paroxysmal AF and 65.3% for persistent AF, performing PVI only.

show abstract

Section: Procedural Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pulmonary vein isolation by visually guided laser balloon ablation: single-center 5-year follow-up results

Koopman

Bekelaar

Schurmans

et al. 2023

J Interv Card Electrophysiol

View full text Add to dashboard Cite

show abstract

“…Several balloon-based catheter ablation techniques, including laser balloon ablation (LBA) and cryoballoon ablation (CBA), have been introduced in recent years and emerged as valuable alternatives to conventional radiofrequency CA strategies ( 3 ). Previous studies have demonstrated that balloon-based CA techniques not only have comparable efficacy and safety outcomes but also provide several superiorities, such as shorter procedural and fluoroscopy durations, especially for paroxysmal AF (PAF) patients ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of visually guided laser balloon versus cryoballoon ablation for paroxysmal atrial fibrillation: a systematic review and meta-analysis

Ye,

Chen,

Fan

et al. 2023

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

BackgroundNewly developed catheter ablation (CA) techniques, such as laser balloon ablation (LBA) and cryoballoon ablation (CBA), have been introduced in recent years and emerged as valuable alternatives to conventional radiofrequency CA strategies for paroxysmal atrial fibrillation (PAF) patients. However, evidence comparing LBA and CBA remain controversial. Thus, we conducted this meta-analysis to assess the efficacy and safety between these two techniques.MethodsScientific databases (PubMed, Embase) and relevant websites (the Cochrane Library, ClinicalTrials.gov) were systematically searched from inception to March 2023. The primary outcomes of interest were the AF recurrence and the procedure-related complications. Secondary outcomes included procedural time, fluoroscopy time, and left atrial (LA) dwell time.ResultsSeven clinical trials with a total of 637 patients were finally enrolled. No significant differences were found between LBA and CBA in terms of AF recurrence [16.3% vs. 22.7%, odds ratio (OR) = 0.66, 95% confidence interval (CI): 0.42–1.05, p = 0.078] or total procedural-related complications (8.4% vs. 6.4%, OR = 1.33, 95% CI: 0.71–2.51, p = 0.371). LBA had a significantly longer procedural time [weighted mean difference (WMD) = 38.03 min, 95% CI: 13.48–62.58 min, p = 0.002] and LA dwell time (WMD = 46.67 min, 95% CI: 14.63–78.72 min, p = 0.004) than CBA, but tended to have shorter fluoroscopy time.ConclusionsLBA and CBA treatment have comparable efficacy and safety for PAF patients. LBA was associated with longer procedural and LA dwell times compared with CBA. Further large-scale studies are warranted to compare these two techniques with the newest generations.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=426513, identifier (CRD42023426513).

show abstract

Outcomes of catheter ablation versus antiarrhythmic therapy in patients with atrial fibrillation: a systematic review and meta-analysis

Deshpande

Al‐Khadra

Singanallur

et al. 2022

J Interv Card Electrophysiol

View full text Add to dashboard Cite

Comparative efficacy and safety of catheter ablation interventions for atrial fibrillation: comprehensive network meta-analysis of randomized controlled trials

Cited by 4 publications

References 60 publications

Pulmonary vein isolation by visually guided laser balloon ablation: single-center 5-year follow-up results

Pulmonary vein isolation by visually guided laser balloon ablation: single-center 5-year follow-up results

Efficacy and safety of visually guided laser balloon versus cryoballoon ablation for paroxysmal atrial fibrillation: a systematic review and meta-analysis

Outcomes of catheter ablation versus antiarrhythmic therapy in patients with atrial fibrillation: a systematic review and meta-analysis

Contact Info

Product

Resources

About