Safety and efficacy of cryoablation vs. radiofrequency ablation of septal accessory pathways: systematic review of the literature and meta-analyses
| Autor: | Francisco Fernández-Avilés, Jesús Almendral, Pedro L. Sánchez, Gabriel Eidelman, Pablo Ávila, Loreto Bravo, Felipe Atienza, Mauricio Pelliza, T. Datino, Angel Arenal, Evaristo Castellanos, Gerard Loughlin, Esteban G. Torrecilla, Nieves Martínez-Alzamora |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Ablation Techniques Radiofrequency ablation medicine.medical_treatment Action Potentials 030204 cardiovascular system & hematology Cryosurgery law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Heart Rate Recurrence Risk Factors law Physiology (medical) medicine Humans 030212 general & internal medicine Atrioventricular Block Child Aged business.industry Arrhythmias Cardiac Cryoablation Middle Aged Ablation medicine.disease Accessory Atrioventricular Bundle Treatment Outcome surgical procedures operative Child Preschool Meta-analysis Cohort Catheter Ablation Female Radiology Cardiology and Cardiovascular Medicine business therapeutics Atrioventricular block |
| Zdroj: | EP Europace. 20:1334-1342 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Aims Radiofrequency ablation (RFA) of septal accessory pathways (APs) is associated with a significant rate of first procedure failures and complications. Cryoablation is an alternative energy source but there are no studies comparing both ablation techniques. We aimed to systematically review the literature and compare the efficacy and safety of cryoablation vs. RFA of septal APs. Methods and results We conducted two separate meta-analysis of cryoablation and RFA of septal APs and calculated the global estimates of the efficacy and safety. Sixty-four articles were included: 38 articles reporting RFA and 27 articles reporting cryoablation procedures. Additionally, we included the previously non-published cryoablation registry of septal APs performed at our institution. Overall, 4244 septal APs constitute our study population, 3495 in the RFA cohort and 749 in the cryoablation cohort. Acute procedural success rate of cryoablation was 86.0% (95% CI 81.6-89.4%) and RFA 89.0% (95% CI 86.8-91.0%). Recurrence rate of cryoablation was 18.1% (95% CI 14.8-21.8%) and RFA 9.9% (95% CI 8.2-12.0%). Long-term success rate after multiple ablation procedures of cryoablation was 75.9% (95% CI 68.2-82.3%) and RFA 88.4% (95% CI 84.7-91.3%). There were no reported cases of persistent atrioventricular block (AVB) with cryoablation and 2.7% (95% CI 2.2-3.4%) with RFA. Conclusion Studies of RFA for treatment of septal APs report higher efficacy rates than do studies using cryoablation, but a significantly higher rate of AVB. |
| Databáze: | OpenAIRE |
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