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October 25, 2018PLoS ONEOpen Access

The safety and efficacy of second-generation cryoballoon ablation plus catheter ablation for persistent atrial fibrillation: A systematic review and meta-analysis

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Why the study?

Does a 'PVI-plus' strategy using second-generation cryoballoon ablation improve clinical success rates compared to a 'PVI-only' strategy in patients with persistent atrial fibrillation?

Population

879 patients with drug-refractory symptomatic persistent atrial fibrillation from 5 studies, mean age 63…

Comparison

Second-generation cryoballoon ablation using a… vs Second-generation cryoballoon ablation using a…

Design

Meta-analysis

Follow-up

median 27 months

Authors

MSMengjiao ShaoLSLuxiang ShangJSJia Shi

Discussion

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Member takes

Overview

Supports PVI-plus over PVI-only in persistent AF; extends cryoballoon evidence to mid-term arrhythmia freedom.

Structured PICO

Does a 'PVI-plus' strategy using second-generation cryoballoon ablation improve clinical success rates compared to a 'PVI-only' strategy in patients with persistent atrial fibrillation?

P
Population
879 patients with drug-refractory symptomatic persistent atrial fibrillation (PerAF) from 5 studies, mean age 63, 69.5% male. Mean CHA2DS2-VASc score 2.1.
I
Intervention
Second-generation cryoballoon (2G-CB) ablation using a 'PVI-plus' strategy (pulmonary vein isolation plus other substrate modifications/extra-PV lesions).
C
Comparator
Second-generation cryoballoon (2G-CB) ablation using a 'PVI-only' strategy (pulmonary vein isolation alone).
O
Outcome
Clinical success rate (no episode of atrial fibrillation or any atrial arrhythmia lasting longer than 30 seconds without administration of antiarrhythmic drugs) at mid-term follow-up (median 27 months).composite

In patients with persistent atrial fibrillation, a 'PVI-plus' strategy using second-generation cryoballoon ablation significantly improves mid-term freedom from atrial arrhythmias compared to PVI alone, without increasing complications.

Limitations

  • Lack of randomized controlled trials meeting inclusion criteria
  • Inability to perform detailed subgroup analyses due to lack of correlated studies

Cite This Study

Shao et al. (2018) studied this question.

synapsesocial.com/papers/6a20247e35281a23f90dfe00https://doi.org/10.1371/journal.pone.0206362
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Long-term Outcomes after Second-Generation Cryoballoon Ablation of Atrial Fibrillation and Analysis of Risk Factors Related to Recurrence2022 · 2 citations
  2. 2One‐Year Clinical Outcome of Pulmonary Vein Isolation Using the Second‐Generation Cryoballoon: A Meta‐Analysis2015 · 27 citations
  3. 3Long‐term outcomes of pulmonary vein isolation using second‐generation cryoballoon during atrial fibrillation ablation2019 · 26 citations
  4. 4Efficacy and safety of cryoballoon pulmonary vein isolation for paroxysmal and persistent atrial fibrillation: A comparison with radiofrequency ablation2022 · 7 citations
  5. 5One-year follow-up after second-generation cryoballoon ablation for atrial fibrillation in a large cohort of patients: a single-centre experience2015 · 54 citations