The use of intracardiac echocardiography catheters in endocardial ablation of cardiac arrhythmia: Meta-analysis of efficiency, effectiveness, and safety outcomes.
Arrhythmias, Cardiac
/ diagnostic imaging
Cardiac Catheterization
/ adverse effects
Cardiac Catheters
Catheter Ablation
/ adverse effects
Echocardiography
/ instrumentation
Female
Fluoroscopy
Humans
Male
Middle Aged
Operative Time
Predictive Value of Tests
Radiation Exposure
/ adverse effects
Treatment Outcome
ICE
arrhythmia
catheter ablation
intracardiac echocardiography
intracardiac ultrasound
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
30
10
2019
revised:
10
01
2020
accepted:
20
01
2020
pubmed:
25
1
2020
medline:
16
12
2020
entrez:
25
1
2020
Statut:
ppublish
Résumé
The optimal use of intracardiac echocardiography (ICE) may reduce fluoroscopy time and procedural complications during endocardial ablation of cardiac arrhythmias. Due to limited evidence in this area, we conducted the first systematic literature review and meta-analysis to evaluate outcomes associated with the use of ICE. Studies reporting the use of ICE during ablation procedures vs without ICE were searched using PubMed/MEDLINE. A meta-analysis was performed on the 19 studies (2186 patients) meeting inclusion criteria, collectively representing a broad range of arrhythmia mechanisms. Use of ICE was associated with significant reductions in fluoroscopy time (Hedges' g -1.06; 95% confidence interval [CI] -1.81 to -0.32; P < .01), fluoroscopy dose (Hedges' g -1.27; 95% CI -1.91 to -0.62; P < .01), and procedure time (Hedges' g -0.35; 95% CI -0.64 to -0.05; P = .02) vs ablation without ICE. A 6.95 minute reduction in fluoroscopy time and a 15.2 minute reduction in procedure time was observed between the ICE vs non-ICE groups. These efficiency gains were not associated with any decreased effectiveness or safety. Sensitivity analyses limiting studies to an atrial fibrillation (AF) only population yielded similar results to the main analysis. The use of ICE in the ablation of cardiac arrhythmias is associated with significantly lower fluoroscopy time, fluoroscopy dose, and shorter procedure time vs ablation without ICE. These efficiency improvements did not compromise the clinical effectiveness or safety of the procedure.
Identifiants
pubmed: 31976603
doi: 10.1111/jce.14367
pmc: PMC7078927
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
664-673Informations de copyright
© 2020 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals, Inc.
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