Safety and Efficacy of High Power Shorter Duration Ablation Guided by Ablation Index or Lesion Size Index in Atrial Fibrillation Ablation: A Systematic Review and Meta-Analysis
| Autor: | Xing Liu, Chun Gui, Weiming Wen, Yan He, Weiran Dai, Guoqiang Zhong |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Journal of Interventional Cardiology, Vol 2021 (2021) |
| Druh dokumentu: | article |
| ISSN: | 0896-4327 1540-8183 |
| DOI: | 10.1155/2021/5591590 |
| Popis: | Background. High power shorter duration (HPSD) ablation may lead to safe and rapid lesion formation. However, the optimal radio frequency power to achieve the desired ablation index (AI) or lesion size index (LSI) is insubstantial. This analysis aimed to appraise the clinical safety and efficacy of HPSD guided by AI or LSI (HPSD-AI or LSI) in patients with atrial fibrillation (AF). Methods. The Medline, PubMed, Embase, Web of Science, and the Cochrane Library databases from inception to November 2020 were searched for studies comparing HPSD-AI or LSI and low power longer duration (LPLD) ablation. Results. Seven trials with 1013 patients were included in the analysis. The analyses verified that HPSD-AI or LSI revealed benefits of first-pass pulmonary vein isolation (PVI) (RR: 1.28; 95% CI: 1.05–1.56, P = 0.01) and acute pulmonary vein reconnection (PVR) (RR: 0.65; 95% CI: 0.48–0.88, P = 0.005) compared with LPLD. HPSD-AI or LSI showed higher freedom from atrial tachyarrhythmia (AT) (RR = 1.32, 95% CI: 1.14–1.53, P = 0.0002) in the subgroup analysis of studies with PVI ± (with or without additional ablation beyond PVI). HPSD-AI or LSI could short procedural time (WMD: −22.81; 95% CI, −35.03 to −10.60, P = 0.0003), ablation time (WMD: −10.80; 95% CI: −13.14 to −8.46, P |
| Databáze: | Directory of Open Access Journals |
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