Comparison of higher-power and conventional power ablation of atrial
fibrillation using contact-force sensing catheters: A systematic review
and meta-analysis
Abstract
Abstract Background: Contact-force sensing catheters are widely used in
catheter ablation. The technique of high-power ablation has gained a
growing attention in recent years. Our purpose of this meta-analysis is
to compare the efficacy and safety between higher-power and conventional
power ablation of atrial fibrillation (AF) by contact-force sensing
catheters. Methods: We identified studies through searching MEDLINE,
EMBASE, the Web of Science, Scopus and the Cochrane Library from
inception up until July 2020. The primary outcomes were the recurrence
of atrial tachyarrhythmia and complications. The secondary outcomes were
acute reconnections of pulmonary veins(PVs), ablation time, and the
total procedural time. Results: We identified four nonrandomized,
observational studies (nROS) involving 231 patients with high-power
ablation and 239 patients with conventional power ablation. There were
insignificant differences in the recurrence rate of atrial
tachyarrhythmia (14.2% versus 20.5%, OR: 0.64, 95%CI: 0.39 to 1.04, Z
= 1.82, P = 0.07) and clinical complications (1.7% versus 2.5%, OR:
0.72, 95%CI: 0.21 to 2.47, Z = 0.51, P = 0.61) between high-power
versus conventional power ablation. The high-power group was fewer in
acute PVs reconnections (P = 0.0001) , shorter in ablation time (P
< 0.0001) , and the total procedural time (P <
0.0001) compared with conventional power group. Conclusion: High-power
ablation of AF was safe and efficient compared with that of conventional
power ablation, and reduced ablation time and the total procedural time.