Meta-Analysis of Contemporary Atrial Fibrillation Ablation Strategies: Irrigated Radiofrequency Versus Duty-Cycled Phased Radiofrequency Versus Cryoballoon Ablation

JACC. Clinical Electrophysiology
Peter KabungaRaymond W Sy

Abstract

Using data from published studies, we performed a comparison of the 3 most commonly used atrial fibrillation (AF) ablation technologies in terms of efficacy and procedural duration. Catheter ablation is an effective treatment of atrial fibrillation (AF). Until recently, it has been performed with point-by-point delivery of irrigated radiofrequency energy (IRF). Phased duty-cycled radiofrequency (PRF) and cryoballoon ablation (CBA) have been introduced as alternatives to simplify AF ablation. Electronic searches of 6 databases was performed, and eligible studies with IRF, PRF, or CBA as cohort arms were included. These ablation strategies were compared directly by using conventional frequentist meta-analysis and indirectly by using network meta-analysis, with outcomes graded using rank probability analysis. Direct conventional meta-analysis using all available published data showed that PRF was associated with an apparently higher freedom from AF than IRF (66.4% vs. 58%, respectively, p = 0.007), whereas CBA was comparable with IRF (64.8% vs. 62%, respectively, p = 0.99). PRF was associated with shorter procedural time (p < 0.0001), whereas there was a trend toward shorter procedural time with CBA than with IRF (p = 0.10). Indir...Continue Reading

References

Dec 30, 1996·Statistics in Medicine·J P Higgins, A Whitehead
Sep 3, 1998·The New England Journal of Medicine·M HaïssaguerreJ Clémenty
Apr 12, 2003·Pacing and Clinical Electrophysiology : PACE·Ali ErdoganHeinz F Pitschner
Dec 10, 2009·Circulation. Arrhythmia and Electrophysiology·Riccardo CappatoElia Biganzoli
Jan 9, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Gian Battista ChierchiaPedro Brugada
Sep 11, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Thomas NeumannHeinz-Friedrich Pitschner
Nov 19, 2010·PloS One·Sarah DoneganCatrin Tudur-Smith
Jan 5, 2011·International Journal of Cardiology·Christine TivigChristoph Scharf
Feb 1, 2011·International Journal of Cardiology·Martin SchmidtMarcos Daccarett
Apr 5, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jason G AndradeMarc Dubuc
Apr 5, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Alex BittnerLars Eckardt
Jun 15, 2011·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Jeroen P JansenJoseph C Cappelleri
Sep 17, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Claudia Herrera SiklódyDietmar Trenk
Feb 23, 2012·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Rypko J BeukemaVivek Reddy
Mar 13, 2012·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Yaariv KhaykinAtul Verma
May 5, 2012·Indian Pacing and Electrophysiology Journal·Jason G AndradePaul Khairy
May 12, 2012·Journal of the American College of Cardiology·Gregory Y H LipLars Hvilsted Rasmussen
Oct 26, 2012·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Khang-Li LooiDavid Begley
Dec 4, 2012·Journal of the American College of Cardiology·Jürgen VogtGeorg Nölker
Jan 1, 2013·Circulation. Arrhythmia and Electrophysiology·David E HainesEmanuel Kanal
Feb 23, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Alexander FürnkranzJulian K R Chun
May 25, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Helena MalmborgCarina Blomström-Lundqvist
Jul 17, 2013·Annals of Internal Medicine·Andrea CiprianiGeorgia Salanti
Sep 11, 2013·Journal of Cardiovascular Electrophysiology·Mikael HanninenPeter Leong-Sit
Sep 28, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Stephan ZellerhoffGerold Mönnig
Oct 10, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Nicasio Pérez-CastellanoJulián Pérez-Villacastín
Oct 19, 2013·Journal of Cardiovascular Electrophysiology·Martin SchmidtEllen Hoffmann
Dec 10, 2013·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Gian-Battista ChierchiaPedro Brugada
Dec 19, 2013·Circulation·Sumeet S ChughChristopher J L Murray
Jan 21, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Y De GreefM Duytschaever
Mar 13, 2014·Circulation. Arrhythmia and Electrophysiology·Andreas MetznerErik Wissner

❮ Previous
Next ❯

Related Concepts

Related Feeds

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.