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

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Wei Mao¹  Qian Chen²  Guangci Fan²  Xiao Wang³  Wenyi Ye³  JuanJuan Li³  Xinbin Zhou³ 

[1]Department of Cardiology, Zhejiang Hospital, Hangzhou, China

[2]Qingdao Hiser Hospital Affiliated of Qingdao University (Qingdao Traditional Chinese Medicine Hospital), Qingdao, China

[3]The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China

关键词: paroxysmal atrial fibrillation;    catheter ablation;    laser balloon ablation;    cryoballoon ablation;    meta-analysis;   

DOI  :  10.3389/fcvm.2023.1229223

 received in 2023-05-31, accepted in 2023-08-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

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).

【 授权许可】

Unknown   
© 2023 Ye, Chen, Fan, Zhou, Wang, Mao and Li.