Comparative Efficacy and Safety Profiles of High-power, Short-duration and Low-power, Long-duration Radiofrequency Ablation in Atrial Fibrillation: A Systematic Review and Meta-analysis.

Autor:	Kumar S; Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, Pakistan., Khatri M; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Kumar S; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Partab FNU; Department of Medicine, Chandka Medical College, SMBBMU Larkana, Larkana, Pakistan., Manoj Kumar FNU; Department of Medicine, Jinnah Sindh Medical University (JSMU), Karachi, Pakistan., Neha FNU; Department of Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, Pakistan., Suman FNU; Department of Medicine, Chandka Medical College, SMBBMU Larkana, Larkana, Pakistan., Rai L; Department of Medicine, Liaquat University of Medical and Health Science, Jamshoro, Pakistan., Sangam FNU; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan., Kumari S; Department of Medicine, Chandka Medical College, SMBBMU Larkana, Larkana, Pakistan., Islam H; Department of Medicine, Punjab Medical College, Faisalabad, Pakistan., Islam R; Department of Medicine, Punjab Medical College, Faisalabad, Pakistan., Patel T; Department of Medicine, American University of Antigua, Osbourn, Antigua and Barbuda.
Jazyk:	angličtina
Zdroj:	The Journal of innovations in cardiac rhythm management [J Innov Card Rhythm Manag] 2023 Jul 15; Vol. 14 (7), pp. 5514-5527. Date of Electronic Publication: 2023 Jul 15 (Print Publication: 2023).
DOI:	10.19102/icrm.2023.14072
Abstrakt:	High-power, short-duration (HPSD) radiofrequency (RF) ablation is expected to be more effective and safer than low-power, long-duration (LPLD) RF ablation in treating atrial fibrillation (AF). Given the limited data available, the findings are controversial. This meta-analysis evaluated whether the clinical effects of HPSD outweigh those of LPLD. A systematic search of PubMed, Embase, and Google Scholar databases identified studies comparing HPSD to LPLD ablation. All the analyses used the random-effects model. This analysis included 21 studies with a total of 4,169 patients. Pooled analyses revealed that HPSD was associated with a lower recurrence of atrial tachyarrhythmias (ATAs) at 1 year (relative risk [RR], 0.62; 95% confidence interval [CI], 0.50-0.78; P = .00001; I 2 = 0%). Furthermore, the HPSD approach reduced the risk of AF recurrence (RR, 0.64; 95% CI, 0.40-1.01; P = .06; I 2 = 86%). The HPSD approach was associated with a lower risk of esophageal thermal injury (ETI) (RR, 0.78; 95% CI, 0.58-1.04; P = .09; I 2 = 73%). The HPSD strategy increased first-pass pulmonary vein (PV) isolation (PVI) and decreased acute PV reconnection (PVR), both of which were predominantly manifested in bilateral and left PVs. HPSD facilitated a reduction in procedural time, number of lesions created during PVI, and fluoroscopy time. The HPSD method reduces ETI, PVR, and recurrent AF. The HPSD approach also reduced the procedural time, number of lesions created during PVI, fluoroscopy time, and post-ablation AF relapse in 1 year, improving patient outcomes and safety. Competing Interests: The authors report no conflicts of interest for the published content. No funding information was provided. (Copyright: © 2023 Innovations in Cardiac Rhythm Management.)
Databáze:	MEDLINE
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