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Ultrasound-guided femoral venipuncture for catheter ablation of atrial fibrillation 超声引导股静脉穿刺用于心房颤动的导管消融术
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-11 DOI: 10.1007/s10840-024-01918-4
Jana Hašková, Josef Kautzner, Petr Peichl, Predrag Stojadinovič, Bashar Aldhoon, Peter Štiavnický, Eva Borišincová, Jiří Plášek, Robert Čihák, Dan Wichterle
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引用次数: 0
Catheter ablation for atrial fibrillation in patients with prior left atrial appendage occlusion device 曾使用左房阑尾闭塞器的患者心房颤动的导管消融术
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-11 DOI: 10.1007/s10840-024-01914-8
Jakrin Kewcharoen, Kuldeep Shah, Rahul Bhardwaj, Tahmeed Contractor, Davendra Ramsingh, Mohit K. Turagam, Ravi Mandapati, Dhanunjaya Lakkireddy, Jalaj Garg

Background

The safety and efficacy of CA for AF and left-sided atrial arrhythmias (AA) in patients with left atrial appendage occlusion (LAAO) devices are lacking.

Methods

This is a single-center retrospective registry that included all patients with prior LAAO who underwent catheter ablation for AF or left-sided atrial arrhythmia from January 2020–January 2023. The primary outcomes were procedure-related complications, device-related complications, AA recurrence, and stroke.

Results

A total of 30 patients with prior LAAO were included in the analysis (mean age 75.1 ± 7.1 years old, 50% male, mean CHA2DS2-VASc score 4 ± 1.6, 46.7% paroxysmal AF, 73.3% had prior AF ablation, mean time to ablation 475 ± 365 days). 93.3% (n = 28) and 6.6% (n = 2) patients had ablation for AF (46.7% paroxysmal, 36.7% persistent, 10% long-standing persistent) and left-sided atrial tachycardia, respectively. 16.7% (n = 5) patients underwent ablation along the left atrial appendage ostium, and 3.3% (n = 1) underwent Vein of Marshall alcohol ablation. There were 3 (10%) peri-procedural complications (1 access hematoma and two pericardial effusions requiring intervention—none related to left atrial appendage ostium or alcohol ablation). During the mean follow-up of 440 ± 379 days, 40% (n = 12) patients had AA recurrence (91.6% AF, 8.3% atrial tachycardia), of which five patients needed repeat ablation, and two patients were readmitted for heart failure. There was no stroke or any device-related complications, including new peri-device leaks or device-related thrombosis in patients who had follow-up imaging studies (n = 11, 36.7%).

Conclusion

Catheter ablation for AF (including VoM alcohol ablation) in patients with prior LAAO devices is feasible and safe with favorable outcomes.

Graphical Abstract

背景目前尚缺乏对使用左心房阑尾闭塞(LAAO)装置的房颤和左侧房性心律失常(AA)患者进行CA治疗的安全性和有效性研究。方法这是一项单中心回顾性登记,纳入了2020年1月至2023年1月期间所有因房颤或左侧房性心律失常而接受导管消融术的既往LAAO患者。结果 共有 30 名既往 LAAO 患者纳入分析(平均年龄为 75.1 ± 7.1 岁,50% 为男性,平均 CHA2DS2-VASc 评分为 4 ± 1.6,46.7% 为阵发性房颤,73.3% 曾接受房颤消融术,平均消融时间为 475 ± 365 天)。93.3%(28 人)和 6.6%(2 人)的患者分别因阵发性房颤(46.7% 阵发性、36.7% 持续性、10% 长期持续性)和左侧房性心动过速而进行了消融术。16.7%(5 人)的患者接受了沿左心房附壁的消融术,3.3%(1 人)的患者接受了马歇尔静脉酒精消融术。有 3 例(10%)围手术期并发症(1 例入路血肿和 2 例需要介入治疗的心包积液,均与左心房阑尾骨膜或酒精消融无关)。在平均 440 ± 379 天的随访期间,40%(n = 12)的患者出现房颤复发(91.6% 为房颤,8.3% 为房性心动过速),其中 5 名患者需要再次消融,2 名患者因心力衰竭再次入院。在接受随访影像学检查的患者(11 人,36.7%)中,没有发生中风或任何与设备相关的并发症,包括新的设备周围渗漏或与设备相关的血栓。
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引用次数: 0
Inadvertent 3830 pacing lead placement in the left ventricle through an atrial septal defect in a congenitally corrected transposition of great arteries patient: a multidisciplinary approach 先天性大动脉转位矫正患者无意中通过房间隔缺损将 3830 起搏导线置入左心室:一种多学科方法
IF 1.8 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-10 DOI: 10.1007/s10840-024-01919-3
Federico Migliore, Raimondo Pittorru, Manuel De Lazzari, Nicola Pradegan, Francesco Zanon, Lina Marcantoni, Fabio Scattolin, Gino Gerosa, Giuseppe Tarantini
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引用次数: 0
Safety, efficacy, and quality of life outcomes of pulsed field ablation in Japanese patients with atrial fibrillation: results from the PULSED AF trial. 日本心房颤动患者脉冲场消融术的安全性、疗效和生活质量:PULSED 心房颤动试验的结果。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-07 DOI: 10.1007/s10840-024-01912-w
Teiichi Yamane, Tetsuo Sasano, Hirofumi Tomita, Daisetsu Aoyama, Shinsuke Miyazaki, Masateru Takigawa, Masaomi Kimura, Taihei Itoh, Seigo Yamashita, Jada M Selma, Jeffrey Cerkvenik, Atul Verma, Hiroshi Tada

Background: Pulsed field ablation (PFA), a novel treatment for atrial fibrillation (AF), has yet to be evaluated in a Japanese cohort.

Methods: In this sub-analysis of the PULSED AF trial, 12-month outcomes of paroxysmal AF (PAF) and persistent AF (PsAF) patients treated with PFA in four Japan centers were assessed. After a 90-day blanking period, primary efficacy was determined via freedom from a composite endpoint of acute procedural failure, arrhythmia recurrence, or antiarrhythmic drug escalation over 1 year. Patient improvement was evaluated via two quality of life (QoL) surveys (AFEQT and EQ-5D) at baseline and 12 months.

Results: The analysis included 32 patients, 16 PAF and 16 PsAF, with PAF patients averaging 61.1 ± 10.6 years and PsAF patients averaging 62.8 ± 11.5 years of age. Females made up 31% of PAF and 25% of PsAF cohorts. Acute pulmonary vein isolation was achieved in 100% of both cohorts. The primary efficacy success rate at 12 months was 75.0% for PAF and 56.3% for PsAF patients. No primary safety events occurred. The mean AFEQT score significantly increased for both PAF (25.9 points, p < 0.0001) and PsAF (13.2 points, p = 0.0002) patients, while the EQ-5D-5L score improved significantly for PAF (0.12 points, p = 0.048) patients but not for PsAF (0.04 points, p = 0.08) patients.

Conclusions: Similar to outcomes in the global cohort, ablation with the PulseSelect™ PFA catheter was efficient, effective, and safe in a Japanese population, resulting in improved QoL for PAF and PsAF patients.

Clinical trial registration: ClinicalTrials.gov Identifier: NCT04198701.

背景:脉冲场消融术(PFA)是治疗心房颤动(AF)的一种新型疗法,但尚未在日本人群中进行评估:在这项 PULSED 心房颤动试验的子分析中,对日本四个中心接受脉冲场消融术治疗的阵发性房颤(PAF)和持续性房颤(PsAF)患者的 12 个月疗效进行了评估。经过 90 天的空白期后,主要疗效通过 1 年内无急性手术失败、心律失常复发或抗心律失常药物升级等复合终点来确定。在基线和12个月时,通过两项生活质量(QoL)调查(AFEQT和EQ-5D)评估患者的改善情况:分析包括 32 名患者,其中 16 名 PAF 患者和 16 名 PsAF 患者,PAF 患者平均年龄(61.1 ± 10.6)岁,PsAF 患者平均年龄(62.8 ± 11.5)岁。在 PAF 和 PsAF 患者中,女性分别占 31% 和 25%。两组患者中,100% 实现了急性肺静脉隔离。在 12 个月的主要疗效成功率方面,PAF 患者为 75.0%,PsAF 患者为 56.3%。未发生主要安全性事件。PAF(25.9 分,p < 0.0001)和 PsAF(13.2 分,p = 0.0002)患者的平均 AFEQT 得分均显著增加,而 PAF(0.12 分,p = 0.048)患者的 EQ-5D-5L 得分显著改善,但 PsAF(0.04 分,p = 0.08)患者的 EQ-5D-5L 得分没有改善:与全球队列的结果相似,在日本人群中使用 PulseSelect™ PFA 导管进行消融是高效、有效和安全的,从而改善了 PAF 和 PsAF 患者的 QoL:临床试验注册:ClinicalTrials.gov Identifier:临床试验注册:ClinicalTrials.gov Identifier:NCT04198701。
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引用次数: 0
Omnipolar mapping for increased precision in atrial fibrillation ablation. 用于提高心房颤动消融精确度的全极绘图。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-05 DOI: 10.1007/s10840-024-01917-5
Shivaraj Patil, Abhishek Deshmukh, Christopher V DeSimone
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引用次数: 0
Catheter ablation alone versus catheter ablation with combined percutaneous left atrial appendage closure for atrial fibrillation: a systematic review and meta-analysis. 单纯导管消融与导管消融联合经皮左心房阑尾封堵术治疗心房颤动:系统综述与荟萃分析。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-04 DOI: 10.1007/s10840-024-01915-7
Joey Junarta, Muhammad U Siddiqui, Ehab Abaza, Peter Zhang, Aarash Roshandel, Chirag R Barbhaiya, Lior Jankelson, David S Park, Douglas Holmes, Larry A Chinitz, Anthony Aizer

Background: Combined catheter ablation (CA) with percutaneous left atrial appendage closure (LAAC) may produce comprehensive treatment for atrial fibrillation (AF) whereby rhythm control is achieved and stroke risk is reduced without the need for chronic oral anticoagulation. However, the efficacy and safety of this strategy is still controversial.

Methods: This meta-analysis was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Medline, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies. The risk of bias was assessed using the Modified Newcastle-Ottawa scale and Cochrane risk of bias tool. Eligible studies reported outcomes in patients with AF who underwent combined CA and LAAC vs CA alone. Studies performing CA without pulmonary vein isolation were excluded.

Results: Eight studies comprising 1878 patients were included (2 RCT, 6 observational). When comparing combined CA and LAAC vs CA alone, pooled results showed no difference in arrhythmia recurrence (risk ratio (RR) 1.04; 95% confidence interval (CI) 0.82-1.33), stroke or systemic embolism (RR 0.78; 95% CI 0.27-2.22), or major periprocedural complications (RR 1.28; 95% CI 0.28-5.89). Total procedure time was shorter with CA alone (mean difference 48.45 min; 95% CI 23.06-74.62).

Conclusion: Combined CA with LAAC for AF is associated with similar rates of arrhythmia-free survival, stroke, and major periprocedural complications when compared to CA alone. A combined strategy may be as safe and efficacious for patients at moderate to high risk for bleeding events to negate the need for chronic oral anticoagulation.

背景:联合导管消融术(CA)与经皮左心房阑尾封堵术(LAAC)可对心房颤动(AF)进行综合治疗,从而达到控制心律和降低中风风险的目的,而无需长期口服抗凝药。然而,这一策略的有效性和安全性仍存在争议:本荟萃分析根据《系统综述和荟萃分析首选报告项目》指南进行报告。对 Medline、Scopus 和 Cochrane Central Register of Controlled Trials 进行了系统检索,以确定相关研究。采用改良纽卡斯尔-渥太华量表和 Cochrane 偏倚风险工具评估偏倚风险。符合条件的研究报告了房颤患者联合接受 CA 和 LAAC 与单独接受 CA 的结果。未进行肺静脉隔离的 CA 研究被排除在外:结果:共纳入了 8 项研究,包括 1878 名患者(2 项 RCT,6 项观察性研究)。在比较联合 CA 和 LAAC 与单独 CA 时,汇总结果显示在心律失常复发(风险比 (RR) 1.04; 95% 置信区间 (CI) 0.82-1.33)、中风或全身性栓塞(RR 0.78; 95% CI 0.27-2.22)或主要围手术期并发症(RR 1.28; 95% CI 0.28-5.89)方面没有差异。单用CA的手术总时间更短(平均差异48.45分钟;95% CI 23.06-74.62):结论:与单纯 CA 相比,联合 CA 和 LAAC 治疗房颤的无心律失常生存率、中风率和主要围手术期并发症发生率相似。对于有中度至高度出血事件风险的患者来说,联合策略可能同样安全有效,从而无需长期口服抗凝药。
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引用次数: 0
Bangungut, risk stratification and late potentials in Brugada syndrome. Brugada综合征的Bangungut、风险分层和晚期电位。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 Epub Date: 2024-02-20 DOI: 10.1007/s10840-024-01774-2
Manlio F Márquez, Margarita Dorantes
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引用次数: 0
Rethinking appropriate blanking period after atrial fibrillation ablation. 重新思考心房颤动消融术后的适当空白期。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 Epub Date: 2024-02-16 DOI: 10.1007/s10840-024-01754-6
Naoaki Onishi, Akihira Suenaga, Akinori Yoshida, Takayasu Kobayashi, Shokan Kyo, Maki Oi, Nobuya Higashitani, Fumiko Nakazeki, Naofumi Oyamada, Toshikazu Jinnai, Kazuaki Kaitani

Background: Early recurrence (ER) within a 90-day blanking period (BP) in catheter ablation (CA) for atrial fibrillation (AF) is a risk factor for late recurrence (LR) after 90 days postoperatively. However, few reports have examined them in the second CA and compared them to the first CA. Moreover, in recent years, there have been reports suggesting that BP should be reduced from 90 to 30 days. Therefore, the association between ER and LR in the first and the second CA was examined, and the validity of a 30-day BP was evaluated.

Methods: A total of 511 consecutive patients undergoing the first CA and 116 of these patients undergoing the second CA for AF at a single institution from November 2016 to December 2020 were analyzed retrospectively.

Results: When ER within a 90-day BP was divided into 0-30 days and 31-90 days according to the timing of the last ER episode, the hazard ratios on LR of them relative to no ER were 2.7 {95% confidence interval (CI) 1.7-4.2} and 9.7 (95% CI 6.6-14.3), respectively, for the first CA and 15.3 (95% CI 4.7-50.1) and 44.1 (95% CI 14.0-139.4), respectively, for the second CA.

Conclusions: ER was strongly associated with LR, especially in patients with the last episode of ER more than 30 days after CA. This was pronounced in cases after the second CA, when PVI appeared to be completed. With the current improvement in PVI durability, BP may be acceptable for 30 days.

背景:心房颤动(房颤)导管消融术(CA)90 天空白期(BP)内的早期复发(ER)是术后 90 天后晚期复发(LR)的风险因素。然而,很少有报告对第二次心房颤动导管消融术中的BP进行研究,并将其与第一次心房颤动导管消融术进行比较。此外,近年来有报告建议应将血压从 90 天降至 30 天。因此,我们研究了第一和第二CA中ER和LR之间的关联,并评估了30天血压的有效性:方法:回顾性分析了2016年11月至2020年12月在一家机构接受首次CA治疗的511名连续患者和其中接受第二次CA治疗的116名房颤患者:根据最后一次ER发作的时间将90天BP内的ER分为0-30天和31-90天,第一次CA的ER相对于无ER的LR危险比分别为2.7{95%置信区间(CI)1.7-4.2}和9.7(95% CI 6.6-14.3),第二次CA的ER相对于无ER的LR危险比分别为15.3(95% CI 4.7-50.1)和44.1(95% CI 14.0-139.4):ER与LR密切相关,尤其是在CA后30天以上发生ER的患者中。这在第二次 CA 后的病例中更为明显,当时 PVI 似乎已经完成。随着目前 PVI 耐用性的提高,30 天内的血压是可以接受的。
{"title":"Rethinking appropriate blanking period after atrial fibrillation ablation.","authors":"Naoaki Onishi, Akihira Suenaga, Akinori Yoshida, Takayasu Kobayashi, Shokan Kyo, Maki Oi, Nobuya Higashitani, Fumiko Nakazeki, Naofumi Oyamada, Toshikazu Jinnai, Kazuaki Kaitani","doi":"10.1007/s10840-024-01754-6","DOIUrl":"10.1007/s10840-024-01754-6","url":null,"abstract":"<p><strong>Background: </strong>Early recurrence (ER) within a 90-day blanking period (BP) in catheter ablation (CA) for atrial fibrillation (AF) is a risk factor for late recurrence (LR) after 90 days postoperatively. However, few reports have examined them in the second CA and compared them to the first CA. Moreover, in recent years, there have been reports suggesting that BP should be reduced from 90 to 30 days. Therefore, the association between ER and LR in the first and the second CA was examined, and the validity of a 30-day BP was evaluated.</p><p><strong>Methods: </strong>A total of 511 consecutive patients undergoing the first CA and 116 of these patients undergoing the second CA for AF at a single institution from November 2016 to December 2020 were analyzed retrospectively.</p><p><strong>Results: </strong>When ER within a 90-day BP was divided into 0-30 days and 31-90 days according to the timing of the last ER episode, the hazard ratios on LR of them relative to no ER were 2.7 {95% confidence interval (CI) 1.7-4.2} and 9.7 (95% CI 6.6-14.3), respectively, for the first CA and 15.3 (95% CI 4.7-50.1) and 44.1 (95% CI 14.0-139.4), respectively, for the second CA.</p><p><strong>Conclusions: </strong>ER was strongly associated with LR, especially in patients with the last episode of ER more than 30 days after CA. This was pronounced in cases after the second CA, when PVI appeared to be completed. With the current improvement in PVI durability, BP may be acceptable for 30 days.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1427-1436"},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139741255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Device infection in patients undergoing pacemaker or defibrillator surgery: risk stratification using the PADIT score. 接受起搏器或除颤器手术患者的设备感染:使用 PADIT 评分进行风险分层。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 Epub Date: 2024-01-30 DOI: 10.1007/s10840-024-01759-1
John de Heide, Marisa van der Graaf, Marijn J Holl, Mark G Hoogendijk, Rohit E Bhagwandien, Sip A Wijchers, Dominic A M J Theuns, Tamas Szili-Torok, Felix Zijlstra, Mattie J Lenzen, Sing-Chien Yap

Background: The use of an antibacterial envelope is cost-effective for patients at high risk of developing cardiac implantable electronic device (CIED) infection. The identification of these high-risk patients may be facilitated using a clinical risk score. The aim of the current study is to evaluate the PADIT score for identifying high-risk patients in patients undergoing a CIED procedure in a tertiary academic center.

Methods: This was a retrospective single-center study of consecutive patients undergoing a CIED procedure between January 2016 and November 2021. Patients who received an antibacterial envelope were excluded from this study. The primary endpoint was hospitalization for a CIED infection in the first year after the procedure.

Results: A total of 2333 CIED procedures were performed in the study period (mean age 61.6 ± 16.3 years, male sex 64.5%, previous CIED infection 1.7%, immunocompromised 5.4%). The median PADIT score was 4 (interquartile range, 2-6). CIED infection occurred in 10 patients (0.43%). The PADIT score had good discrimination in predicting major CIED infection (C-statistic 0.70; 95% confidence interval [CI] 0.54 to 0.86, P = 0.03). Using an optimal PADIT score cut-off value of 7, the risk of CIED infection was higher in the patients with a PADIT score of ≥ 7 in comparison to those with a lower PADIT score (1.23% vs. 0.26%, P = 0.02; odds ratio 4.8, 95% CI 1.4 to 16.6, P = 0.01).

Conclusions: The PADIT score is a clinically useful score for identifying patients at high risk of developing CIED infection. The use of an antibacterial envelope in these high-risk patients may be cost-effective.

背景:对心脏植入式电子装置(CIED)感染高风险患者使用抗菌包膜具有成本效益。临床风险评分可帮助识别这些高风险患者。本研究旨在评估 PADIT 评分在三级学术中心接受 CIED 手术患者中识别高风险患者的能力:这是一项回顾性单中心研究,研究对象为2016年1月至2021年11月期间接受CIED手术的连续患者。本研究不包括接受抗菌包膜治疗的患者。主要终点是术后第一年内因CIED感染而住院:研究期间共进行了2333例CIED手术(平均年龄61.6±16.3岁,男性占64.5%,既往CIED感染1.7%,免疫力低下5.4%)。PADIT评分中位数为4分(四分位间范围为2-6分)。10名患者(0.43%)感染了CIED。PADIT评分在预测重大CIED感染方面具有良好的区分度(C统计量为0.70;95%置信区间[CI] 0.54至0.86,P = 0.03)。采用最佳的PADIT评分临界值7,与PADIT评分较低的患者相比,PADIT评分≥7的患者发生CIED感染的风险更高(1.23% vs. 0.26%,P = 0.02;几率比4.8,95% CI 1.4 to 16.6,P = 0.01):PADIT评分是一种临床实用的评分方法,可用于识别CIED感染高风险患者。对这些高危患者使用抗菌包膜可能具有成本效益。
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引用次数: 0
Efficacy and safety of high-power short-duration ablation for atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials. 高功率短时消融术治疗心房颤动的疗效和安全性:随机对照试验的系统回顾和荟萃分析。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 Epub Date: 2024-03-09 DOI: 10.1007/s10840-024-01782-2
Ahmed Mazen Amin, Ramy Ghaly, Ahmed A Ibrahim, Mohamed Ahmed Ali, Omar Almaadawy, Amr Elzahaby, Mohamed Abuelazm, Basel Abdelazeem, Muhammad Bilal Munir

Background: High-power short-duration (HPSD) ablation has emerged as an alternative to conventional standard-power long-duration (SPLD) ablation. We aim to assess the efficacy and safety of HPSD versus SPLD for atrial fibrillation (AF) ablation.

Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL were performed through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI).

Prospero id: CRD42023471797.

Results: We included six RCTs with a total of 694 patients. HPSD was significantly associated with a decreased total procedure time (MD: -22.88 with 95% CI [-36.13, -9.63], P = 0.0007), pulmonary vein isolation (PVI) time (MD: -19.73 with 95% CI [-23.93, -15.53], P < 0.00001), radiofrequency time (MD: -10.53 with 95% CI [-12.87, -8.19], P < 0.00001). However, there was no significant difference between HPSD and SPLD ablation with respect to the fluoroscopy time (MD: -0.69 with 95% CI [-2.00, 0.62], P = 0.30), the incidence of esophageal lesions (RR: 1.15 with 95% CI [0.43, 3.07], P = 0.77), and the incidence of first pass isolation (RR: 0.98 with 95% CI [0.88, 1.08], P = 0.65).

Conclusion: HPSD ablation was significantly associated with decreased total procedure time, PVI time, and radiofrequency time compared with SPLD ablation. On the contrary, SPLD ablation was significantly associated with low maximum temperature.

背景:高功率短持续时间(HPSD)消融术已成为传统标准功率长持续时间(SPLD)消融术的替代方案。我们旨在评估心房颤动(房颤)消融术中高功率短持续时间消融术与标准功率长持续时间消融术的疗效和安全性:截至 2023 年 8 月,我们对从 PubMed、WOS、SCOPUS、EMBASE 和 CENTRAL 检索到的随机对照试验 (RCT) 进行了系统综述和荟萃分析。我们使用 RevMan V. 5.4 使用风险比 (RR) 汇集二分法数据,使用平均差 (MD) 和 95% 置信区间 (CI) 汇集连续数据:CRD42023471797.Results:结果:我们纳入了六项研究,共有 694 名患者。HPSD与手术总时间(MD:-22.88,95% CI [-36.13,-9.63],P = 0.0007)、肺静脉隔离(PVI)时间(MD:-19.73,95% CI [-23.93,-15.53],P 结论:HPSD消融与手术总时间明显相关:与 SPLD 消融术相比,HPSD 消融术明显缩短了手术总时间、PVI 时间和射频时间。相反,SPLD消融术与低最高温度明显相关。
{"title":"Efficacy and safety of high-power short-duration ablation for atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.","authors":"Ahmed Mazen Amin, Ramy Ghaly, Ahmed A Ibrahim, Mohamed Ahmed Ali, Omar Almaadawy, Amr Elzahaby, Mohamed Abuelazm, Basel Abdelazeem, Muhammad Bilal Munir","doi":"10.1007/s10840-024-01782-2","DOIUrl":"10.1007/s10840-024-01782-2","url":null,"abstract":"<p><strong>Background: </strong>High-power short-duration (HPSD) ablation has emerged as an alternative to conventional standard-power long-duration (SPLD) ablation. We aim to assess the efficacy and safety of HPSD versus SPLD for atrial fibrillation (AF) ablation.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL were performed through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI).</p><p><strong>Prospero id: </strong>CRD42023471797.</p><p><strong>Results: </strong>We included six RCTs with a total of 694 patients. HPSD was significantly associated with a decreased total procedure time (MD: -22.88 with 95% CI [-36.13, -9.63], P = 0.0007), pulmonary vein isolation (PVI) time (MD: -19.73 with 95% CI [-23.93, -15.53], P < 0.00001), radiofrequency time (MD: -10.53 with 95% CI [-12.87, -8.19], P < 0.00001). However, there was no significant difference between HPSD and SPLD ablation with respect to the fluoroscopy time (MD: -0.69 with 95% CI [-2.00, 0.62], P = 0.30), the incidence of esophageal lesions (RR: 1.15 with 95% CI [0.43, 3.07], P = 0.77), and the incidence of first pass isolation (RR: 0.98 with 95% CI [0.88, 1.08], P = 0.65).</p><p><strong>Conclusion: </strong>HPSD ablation was significantly associated with decreased total procedure time, PVI time, and radiofrequency time compared with SPLD ablation. On the contrary, SPLD ablation was significantly associated with low maximum temperature.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1445-1461"},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Interventional Cardiac Electrophysiology
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