Cargando…
Cryoballoon Ablation for the Treatment of Atrial Fibrillation: A Meta-analysis
BACKGROUND: Ablation therapy is the treatment of choice in antiarrhythmic drug-refractory atrial fibrillation (AF). It is performed by either cryoballoon ablation (CBA) or radiofrequency abla-tion. CBA is gaining popularity due to simplicity with similar efficacy and complication rate com-pared with...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bentham Science Publishers
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719384/ https://www.ncbi.nlm.nih.gov/pubmed/30539701 http://dx.doi.org/10.2174/1573403X15666181212102419 |
_version_ | 1783447921955438592 |
---|---|
author | Patel, Nirav Patel, Krunalkumar Shenoy, Abhishek Baker, William L. Makaryus, Amgad N. El-Sherif, Nabil |
author_facet | Patel, Nirav Patel, Krunalkumar Shenoy, Abhishek Baker, William L. Makaryus, Amgad N. El-Sherif, Nabil |
author_sort | Patel, Nirav |
collection | PubMed |
description | BACKGROUND: Ablation therapy is the treatment of choice in antiarrhythmic drug-refractory atrial fibrillation (AF). It is performed by either cryoballoon ablation (CBA) or radiofrequency abla-tion. CBA is gaining popularity due to simplicity with similar efficacy and complication rate com-pared with RFA. In this meta-analysis, we compare the recurrence rate of AF and the complications from CBA versus RFA for the treatment of AF. METHODS: We systematically searched PubMed for the articles that compared the outcome of interest. The primary outcome was to compare the recurrence rate of AF between CBA and RFA. We also in-cluded subgroup analysis with complications of pericardial effusion, phrenic nerve palsy and cerebral microemboli following ablation therapy. RESULTS: A total of 24 studies with 3527 patients met our predefined inclusion criteria. Recurrence of AF after CBA or RFA was similar in both groups (RR: 0.84; 95% CI: 0.65, 1.07; I(2)=48%, Cochrane p=0.16). In subgroup analysis, heterogeneity was less in paroxysmal AF (I(2)=0%, Cochrane p=0.46) compared to mixed AF (I(2)=72%, Cochrane p=0.003). Procedure and fluoroscopy time was less by 26.37 and 5.94 minutes respectively in CBA compared to RFA. Complications, pericardial effusion, and silent cerebral microemboli, were not different between the two groups, however, phrenic nerve palsy was exclusively present only in CBA group. CONCLUSION: This study confirms that the effectiveness of CBA is similar to RFA in the treatment of AF with the added advantages of shorter procedure and fluoroscopy times. |
format | Online Article Text |
id | pubmed-6719384 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Bentham Science Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-67193842020-08-01 Cryoballoon Ablation for the Treatment of Atrial Fibrillation: A
Meta-analysis Patel, Nirav Patel, Krunalkumar Shenoy, Abhishek Baker, William L. Makaryus, Amgad N. El-Sherif, Nabil Curr Cardiol Rev Article BACKGROUND: Ablation therapy is the treatment of choice in antiarrhythmic drug-refractory atrial fibrillation (AF). It is performed by either cryoballoon ablation (CBA) or radiofrequency abla-tion. CBA is gaining popularity due to simplicity with similar efficacy and complication rate com-pared with RFA. In this meta-analysis, we compare the recurrence rate of AF and the complications from CBA versus RFA for the treatment of AF. METHODS: We systematically searched PubMed for the articles that compared the outcome of interest. The primary outcome was to compare the recurrence rate of AF between CBA and RFA. We also in-cluded subgroup analysis with complications of pericardial effusion, phrenic nerve palsy and cerebral microemboli following ablation therapy. RESULTS: A total of 24 studies with 3527 patients met our predefined inclusion criteria. Recurrence of AF after CBA or RFA was similar in both groups (RR: 0.84; 95% CI: 0.65, 1.07; I(2)=48%, Cochrane p=0.16). In subgroup analysis, heterogeneity was less in paroxysmal AF (I(2)=0%, Cochrane p=0.46) compared to mixed AF (I(2)=72%, Cochrane p=0.003). Procedure and fluoroscopy time was less by 26.37 and 5.94 minutes respectively in CBA compared to RFA. Complications, pericardial effusion, and silent cerebral microemboli, were not different between the two groups, however, phrenic nerve palsy was exclusively present only in CBA group. CONCLUSION: This study confirms that the effectiveness of CBA is similar to RFA in the treatment of AF with the added advantages of shorter procedure and fluoroscopy times. Bentham Science Publishers 2019-08 2019-08 /pmc/articles/PMC6719384/ /pubmed/30539701 http://dx.doi.org/10.2174/1573403X15666181212102419 Text en © 2019 Bentham Science Publishers https://creativecommons.org/licenses/by-nc/4.0/legalcode This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited. |
spellingShingle | Article Patel, Nirav Patel, Krunalkumar Shenoy, Abhishek Baker, William L. Makaryus, Amgad N. El-Sherif, Nabil Cryoballoon Ablation for the Treatment of Atrial Fibrillation: A Meta-analysis |
title | Cryoballoon Ablation for the Treatment of Atrial Fibrillation: A
Meta-analysis |
title_full | Cryoballoon Ablation for the Treatment of Atrial Fibrillation: A
Meta-analysis |
title_fullStr | Cryoballoon Ablation for the Treatment of Atrial Fibrillation: A
Meta-analysis |
title_full_unstemmed | Cryoballoon Ablation for the Treatment of Atrial Fibrillation: A
Meta-analysis |
title_short | Cryoballoon Ablation for the Treatment of Atrial Fibrillation: A
Meta-analysis |
title_sort | cryoballoon ablation for the treatment of atrial fibrillation: a
meta-analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719384/ https://www.ncbi.nlm.nih.gov/pubmed/30539701 http://dx.doi.org/10.2174/1573403X15666181212102419 |
work_keys_str_mv | AT patelnirav cryoballoonablationforthetreatmentofatrialfibrillationametaanalysis AT patelkrunalkumar cryoballoonablationforthetreatmentofatrialfibrillationametaanalysis AT shenoyabhishek cryoballoonablationforthetreatmentofatrialfibrillationametaanalysis AT bakerwilliaml cryoballoonablationforthetreatmentofatrialfibrillationametaanalysis AT makaryusamgadn cryoballoonablationforthetreatmentofatrialfibrillationametaanalysis AT elsherifnabil cryoballoonablationforthetreatmentofatrialfibrillationametaanalysis |