Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta-analysis.
ablation
atrial fibrillation
endocardial
epicardial
hybrid
Journal
Journal of arrhythmia
ISSN: 1880-4276
Titre abrégé: J Arrhythm
Pays: Japan
ID NLM: 101263026
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
30
07
2021
revised:
09
10
2021
accepted:
21
10
2021
entrez:
10
12
2021
pubmed:
11
12
2021
medline:
11
12
2021
Statut:
epublish
Résumé
Endocardial catheter ablation (ECA) for atrial fibrillation (AF) has limited efficacy. Hybrid convergent procedure (HCP) with both epicardial and endocardial ablation is a novel strategy for AF treatment. In this meta-analysis, we aimed to evaluate the efficacy and safety of HCP in AF ablation. We performed a comprehensive literature search for studies that evaluated the efficacy and safety of HCP compared with ECA for AF. The primary outcome was freedom of atrial arrhythmia (AA). The secondary outcome was the periprocedural complication rate. Pooled relative risk (RR) and corresponding 95% confidence intervals (CIs) were calculated using the random effects model. A total of eight studies, including 797 AF patients (mean age: 60.7 ± 9.8 years, 366 patients with HCP vs. 431 patients with ECA alone), were included. HCP showed a higher rate of freedom of AA compared with ECA (RR: 1.48, 95% CI: 1.13-1.94, Although hybrid ablation was associated with a higher success rate, this should be judged for increased periprocedural adverse events and extended hospital stay. Prospective large-scale randomized trials are needed to validate these results.
Identifiants
pubmed: 34887950
doi: 10.1002/joa3.12653
pii: JOA312653
pmc: PMC8637076
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1459-1467Informations de copyright
© 2021 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.
Déclaration de conflit d'intérêts
The authors declared no conflict of interest.
Références
Circ Arrhythm Electrophysiol. 2012 Feb;5(1):220-8
pubmed: 22334429
Health Technol Assess. 2003;7(27):iii-x, 1-173
pubmed: 14499048
BMJ. 2009 Jul 21;339:b2700
pubmed: 19622552
PLoS One. 2018 Oct 9;13(10):e0205431
pubmed: 30300413
Ann Thorac Surg. 2011 Jun;91(6):1890-8
pubmed: 21619988
N Engl J Med. 2015 May 7;372(19):1812-22
pubmed: 25946280
Circ Arrhythm Electrophysiol. 2014 Feb;7(1):69-75
pubmed: 24446022
BMJ. 2011 Oct 18;343:d5928
pubmed: 22008217
Circulation. 2019 Nov 26;140(22):1779-1788
pubmed: 31630538
J Card Surg. 2020 Jun;35(6):1306-1313
pubmed: 32333456
Circ Arrhythm Electrophysiol. 2020 Dec;13(12):e009288
pubmed: 33185144
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120
Arrhythm Electrophysiol Rev. 2017 Dec;6(4):202-209
pubmed: 29326836
Prog Cardiovasc Dis. 2015 Sep-Oct;58(2):213-20
pubmed: 26272471
Circ Arrhythm Electrophysiol. 2017 Jul;10(7):
pubmed: 28687670
Medicine (Baltimore). 2019 Jan;98(3):e14053
pubmed: 30653113
Arrhythm Electrophysiol Rev. 2020 Aug;9(2):88-96
pubmed: 32983530
Int J Cardiol. 2020 Mar 15;303:49-53
pubmed: 32063280
J Cardiovasc Electrophysiol. 2016 May;27(5):524-30
pubmed: 26766149
Expert Rev Cardiovasc Ther. 2018 Feb;16(2):91-97
pubmed: 29327638
Heart Rhythm. 2021 Feb;18(2):303-312
pubmed: 33045430
Heart Rhythm. 2011 Sep;8(9):1391-7
pubmed: 21699825
Anesth Analg. 2016 Oct;123(4):812-3
pubmed: 27636569
JACC Clin Electrophysiol. 2017 Apr;3(4):341-349
pubmed: 29759446
JAMA. 2000 Apr 19;283(15):2008-12
pubmed: 10789670
Circ Arrhythm Electrophysiol. 2017 Oct;10(10):
pubmed: 29018166
Am J Cardiol. 2013 Oct 15;112(8):1142-7
pubmed: 23831166
J Cardiovasc Electrophysiol. 2018 Aug;29(8):1073-1080
pubmed: 29722468
J Atr Fibrillation. 2017 Feb 28;9(5):1543
pubmed: 29250276