Comparison of phase mapping and electrogram-based driver mapping for catheter ablation in atrial fibrillation.
atrial fibrillation
catheter ablation
driver
meta-analysis
phase-mapping
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
09
09
2018
revised:
01
11
2018
accepted:
14
11
2018
pubmed:
12
12
2018
medline:
31
12
2019
entrez:
12
12
2018
Statut:
ppublish
Résumé
Adjunctive driver-guided ablation in addition to pulmonary vein isolation has been proposed as a strategy to improve procedural success and outcomes for various populations with atrial fibrillation (AF). First, this study aimed to evaluate the different mapping techniques for driver/rotor identification and second to evaluate the benefits of driver/rotor-guided ablation in patients with paroxysmal and persistent AF (PerAF). We searched the electronic database in PubMed using the keywords "atrial fibrillation," "rotor," "rotational driver," "atrial fibrillation source," and "drivers" for both randomized controlled trials and observational controlled trials. Clinical studies reporting efficacy or safety outcomes of driver-guided ablation for paroxysmal AF or (PerAF) were identified. We performed subgroup analyses comparing different driver mapping methods in patients with PerAF. The odds ratios (ORs) with random effects were analyzed. Out of 175 published articles, seven met the inclusion criteria, of which two were randomized controlled trials, one was quasiexperimental study, and four observational studies (three case-controlled studies and one cross-sectional study). Overall, adjunctive driver-guided ablation was associated with higher rates of acute AF termination (OR: 4.62, 95% confidence interval [CI]: 2.12-10.08; P < 0.001), lower recurrence of any atrial arrhythmia (OR: 0.44, 95% CI: 0.30-0.065; P < 0.001), and comparable complication incidence. Adjunctive driver-guided catheter ablation suggested an increased freedom from AF/AT relative to conventional strategies, irrespective of the mapping techniques. Furthermore, phase mapping appears to be superior to electrogram-based driver mapping in PerAF ablation.
Identifiants
pubmed: 30536679
doi: 10.1111/pace.13573
pmc: PMC6542555
mid: NIHMS1015279
doi:
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
216-223Subventions
Organisme : Szu-Yuan Research Foundation of Internal Medicine and Taipei Veterans General Hospital
ID : V107C-054
Pays : International
Organisme : NHLBI NIH HHS
ID : K23 HL070529
Pays : United States
Organisme : Ministry of Science and Technology, Taiwan
ID : MOST 106-2314-B-010-046-MY3
Pays : International
Organisme : Ministry of Science and Technology, Taiwan
ID : 107-2314-B-010-061-MY2
Pays : International
Organisme : Ministry of Science and Technology, Taiwan
ID : MOST 106-2314-B-075-073-MY3
Pays : International
Organisme : Szu-Yuan Research Foundation of Internal Medicine and Taipei Veterans General Hospital
ID : V107C-060
Pays : International
Organisme : NHLBI NIH HHS
ID : K24 HL103800
Pays : United States
Organisme : Szu-Yuan Research Foundation of Internal Medicine and Taipei Veterans General Hospital
ID : V107B-014
Pays : International
Organisme : NHLBI NIH HHS
ID : R01 HL083359
Pays : United States
Organisme : Ministry of Science and Technology, Taiwan
ID : MOST 106-2314-B-075-006-MY3
Pays : International
Informations de copyright
© 2018 Wiley Periodicals, Inc.
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