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Comparison of catheter ablation for paroxysmal atrial fibrillation between cryoballoon and radiofrequency: a meta-analysis

Overview of attention for article published in Journal of Interventional Cardiac Electrophysiology, January 2017
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Title
Comparison of catheter ablation for paroxysmal atrial fibrillation between cryoballoon and radiofrequency: a meta-analysis
Published in
Journal of Interventional Cardiac Electrophysiology, January 2017
DOI 10.1007/s10840-016-0220-8
Pubmed ID
Authors

Chao-feng Chen, Xiao-fei Gao, Xu Duan, Bin Chen, Xiao-hua Liu, Yi-zhou Xu

Abstract

The present systematic review and meta-analysis aimed to assess and compare the safety and efficacy of radiofrequency (RF) and cryoballoon (CB) ablation for paroxysmal atrial fibrillation (PAF). RF and CB ablation are two frequently used methods for pulmonary vein isolation in PAF, but which is a better choice for PAF remains uncertain. A systematic review was conducted in Medline, PubMed, Embase, and Cochrane Library. All trials comparing RF and CB ablation were screened and included if the inclusion criteria were met. A total of 38 eligible studies, 9 prospective randomized or randomized controlled trials (RCTs), and 29 non- RCTs were identified, adding up to 15,496 patients. Pool analyses indicated that CB ablation was more beneficial in terms of procedural time [standard mean difference = -0.58; 95% confidence interval (CI), -0.85 to -0.30], complications without phrenic nerve injury (PNI) [odds ratio (OR) = 0.79; 95% CI, 0.67-0.93; I (2) = 16%], and recrudescence (OR = 0.83; 95% CI, 0.70-0.97; I (2) = 63%) for PAF; however, the total complications of CB was higher than RF. The subgroup analysis found that, compared with non-contact force radiofrequency (non-CF-RF), both first-generation cryoballoon (CB1) and second-generation cryoballoon (CB2) ablation could reduce complications with PNI, procedural time, and recrudescence. However, the safety and efficacy of CB2 was similar to those of CF-RF. Available overall and subgroup data suggested that both CB1 and CB2 were more beneficial than RF ablation, and the main advantages were reflected in comparing them with non-CF-RF. However, CF-RF and CB2 showed similar clinical benefits.

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Geographical breakdown

Country Count As %
Unknown 53 100%

Demographic breakdown

Readers by professional status Count As %
Other 9 17%
Student > Ph. D. Student 6 11%
Student > Bachelor 6 11%
Student > Doctoral Student 4 8%
Student > Postgraduate 3 6%
Other 10 19%
Unknown 15 28%
Readers by discipline Count As %
Medicine and Dentistry 30 57%
Biochemistry, Genetics and Molecular Biology 3 6%
Engineering 2 4%
Nursing and Health Professions 1 2%
Economics, Econometrics and Finance 1 2%
Other 1 2%
Unknown 15 28%