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Meta-Analysis
. 2022 Aug 16:2022:6013474.
doi: 10.1155/2022/6013474. eCollection 2022.

Comparison of Effectiveness and Safety between High-Power Short-Duration Ablation and Conventional Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Shuyu Jin  1   2 , Lu Fu  1 , Junrong Jiang  1 , Xingdong Ye  1 , Huiyi Liu  1 , Yanlin Chen  1 , Sijia Pu  1 , Shulin Wu  1 , Yumei Xue  1   2
Affiliations
Meta-Analysis

Comparison of Effectiveness and Safety between High-Power Short-Duration Ablation and Conventional Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Shuyu Jin et al. J Interv Cardiol. .

Abstract

Aim: We aimed to evaluate the effectiveness and safety between high-power short-duration (HPSD) radiofrequency ablation (RFA) and conventional RFA in patients with atrial fibrillation (AF).

Methods: Studies comparing HPSD and traditional applications in patients undergoing initial catheter ablation for atrial fibrillation from inception through December 2021 were searched on Pubmed, Medline, Cochrane, and Clinicaltrials.gov.

Results: The meta-analysis included seventeen studies with a total of 4934 patients. HPSD group decreased procedure duration (mean difference (MD) -38.28 min, P < 0.001), RF duration (MD -20.51 min, P < 0.001), fluoroscopy duration (MD -5.19 min, P < 0.001), and acute pulmonary vein reconnection (Odds ratio (OR) 0.40, P < 0.001), while improving the freedom from atrial arrhythmia at one year (OR 1.48, 95% confidence interval (CI) 1.12-1.94, P=0.005) and rates of first-pass isolation (OR 8.92, P=0.001). Compared with the conventional group, freedom from atrial arrhythmia at one-year follow-up was higher in the HPSD group without the guidance of AI/LSI (OR 1.66, P=0.01) and studies with a power setting of 40-50 W (OR 1.93, P=0.002). Nevertheless, the two groups had similar effectiveness with a power setting of 50 W in the HPSD RFA (OR 1.10, P=0.52). There was no difference in complications between the two groups (P=0.71).

Conclusion: HPSD RFA was associated with shorter procedure duration, higher freedom from atrial arrhythmia, and comparable safety compared to conventional RFA.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of detailed search progress.
Figure 2
Figure 2
Forest plots of the primary pooled analysis demonstrating the effect of high-power short-duration RFA vs. conventional RFA in patients with atrial fibrillation. Data are mean duration and standard deviation in each group and weighted mean difference. The horizontal line is the 95% CI. The diamond shape is the pooled mean difference of all studies. CI: confidence interval; RFA: radiofrequency ablation. (a) Total procedure duration. (b) Total RF duration. (c) Total fluoroscopy duration.
Figure 3
Figure 3
Forest plots of the primary pooled analysis demonstrating the effect of high-power short-duration RFA vs. conventional RFA in patients with atrial fibrillation. Data are events in each group and weighted odds ratios. The horizontal line is the 95% CI. The diamond shape is the pooled mean difference of all studies. CI: confidence interval; RFA: radiofrequency ablation, PVR: pulmonary vein reconnection. (a) First-pass isolation, (b) freedom from atrial arrhythmia at one year, and (c) acute PVR.
Figure 4
Figure 4
Forest plots of the primary pooled analysis demonstrating the effect of high-power short-duration RFA vs. conventional RFA in patients with atrial fibrillation. Data are events in each group and weighted odds ratios. The horizontal line is the 95% CI. The diamond shape is the pooled mean difference of all studies. CI: confidence interval; RFA: radio frequency ablation; PVR: pulmonary vein reconnection. (a) Total complications. (b) PVR during redo procedures.
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