High power short duration versus low power long duration ablation in patients with atrial fibrillation: A meta-analysis of randomized trials.
Pacing Clin Electrophysiol
; 46(11): 1430-1439, 2023 11.
Article
em En
| MEDLINE
| ID: mdl-37812165
ABSTRACT
BACKGROUND:
High-power-short-duration (HPSD) radiofrequency (RF) ablation is a viable alternative to low-power-long-duration (LPLD) RF for pulmonary vein isolation (PVI). Nevertheless, trials showed conflicting results regarding atrial fibrillation (AF) recurrences and few data concerning complications. Therefore, we conducted a meta-analysis of randomized trials comparing HPSD versus LPLD.METHODS:
We systematically searched the electronic databases for studies published from inception to March 31, 2023 focusing on HPSD versus LPLD. The study endpoints were AF recurrence, procedural times and overall complications.RESULTS:
Five studies enrolling 424 patients met the inclusion criteria (mean age 61.1 years; 54.3% paroxysmal AF; mean LVEF 58.2%). Compared to LPLD, HPSD showed a significantly lower AF recurrence rate [16.3% vs. 30,1%; RR 0.54 (95% CI 0.38-0.79); p = 0.001] at a mean 10.9 months follow-up. Moreover, HPSD led to a significant reduction in total procedural time [MD -26.25 min (95%CI -42.89 to -9.61); p = 0.002], PVI time [MD -26.44 min (95%CI -38.32 to -14.55); p < 0.0001], RF application time [MD -8.69 min (95%CI -11.37 to -6.01); p < 0.00001] and RF lesion number [MD -7.60 (95%CI -10.15 to -5.05); p < 0.00001]. No difference was found in either right [80.4% vs. 78.2%; RR 1.04 (95% CI 0.81-1.32); p = 0.77] or left [92.3% vs. 90.2%; RR 1.02 (95% CI 0.94-1.11); p = 0.58] first-pass isolation and overall complications [6% vs. 3.7%; RR 1.45 (95%CI 0.53-3.99); p = 0.47] between groups.CONCLUSION:
In our metanalysis of randomized trials, HPSD ablation appeared to be associated to a significantly improved freedom from AF and shorter procedures, without increasing the risk of complications.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Veias Pulmonares
/
Fibrilação Atrial
/
Ablação por Cateter
/
Criocirurgia
Tipo de estudo:
Clinical_trials
/
Systematic_reviews
Limite:
Humans
/
Middle aged
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Itália