The use of minimal fluoroscopy for cardiac electrophysiology procedures: A meta‐analysis and review of the literature
| Autor: | Grace Huang, Tong Liu, Benedict Glover, Leonardo Roever, Christien Kh Li, Gary Tse, Mengqi Gong, Lorraine Lok Wing Chiang, Winsy Sin Hui, Sophia Duong, Adrian Baranchuk, Guangping Li, Jeffery Ho, Sze Yi Beh, Yunlong Xia, Kathryn L. Hong |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Clinical Investigations Catheter ablation 030204 cardiovascular system & hematology law.invention 03 medical and health sciences X‐ray 0302 clinical medicine Randomized controlled trial law Atrial Fibrillation catheter ablation medicine Humans Fluoroscopy 030212 general & internal medicine medicine.diagnostic_test business.industry Atrial fibrillation General Medicine Odds ratio medicine.disease radiation Treatment Outcome Meta-analysis Observational study Radiology Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Clinical Cardiology |
| ISSN: | 1932-8737 0160-9289 |
| DOI: | 10.1002/clc.23609 |
| Popis: | Background Conventional catheter ablation involves prolonged exposure to ionizing radiation, potentially leading to detrimental health effects. Minimal fluoroscopy (MF) represents a safer alternative, which should be explored. Data on the safety and efficacy of this technique are limited. Hypothesis Our hypothesis is that MF is of equal efficacy and safety to conventional catheter ablation with the use of fluoroscopy by performing a meta‐analysis of both randomized controlled trials (RCTs) and real‐world registry studies. Methods Pubmed and Embase were searched from their inception to July 2020 for RCTs, cohort and observational studies that assessed the outcomes of catheter ablation using a MF technique versus the conventional approach. Results Fifteen studies involving 3795 patients were included in this meta‐analysis. There was a significant reduction in fluoroscopy and procedural time with no difference in acute success (odds ratio [OR]:0.74, 95% CI: 0.50–1.10, p = .14), long‐term success (OR:0.92, 95% CI: 0.65–1.31, p = .38), arrhythmia recurrence (OR:1.24, 95% CI: 0.75–2.06, p = .97) or rate of complications. (OR:0.83, 95% CI: 0.46–1.48, p = .65). Additionally sub‐group analysis for those undergoing catheter ablation for atrial fibrillation (AF) did not demonstrate a difference in success or complication rates (OR:0.86, 95% CI: 0.30–2.42, p = .77). Multivariate meta‐regression did not identify the presence of moderator variables. Conclusion This updated meta‐analysis demonstrated an overall reduction in procedural and fluoroscopy time for those undergoing a minimal fluoroscopic approach. There was no significant difference in either acute or chronic success rates or complications between a MF approach and conventional approach for the management of all arrhythmias including those undergoing catheter ablation for AF. |
| Databáze: | OpenAIRE |
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