Why the study?
High-power ablation of AF with contact-force sensing catheters has gained growing attention, but its efficacy and safety compared to conventional power ablation needed evaluation.
Does high-power ablation reduce recurrence of atrial tachyarrhythmia and complications in patients with atrial fibrillation compared to conventional power ablation?
Does high-power ablation reduce recurrence of atrial tachyarrhythmia and complications in patients with atrial fibrillation compared to conventional power ablation?
High-power ablation for atrial fibrillation using contact-force sensing catheters offers similar efficacy and safety to conventional power ablation while significantly reducing procedural times.
Higher-power ablation trends toward fewer recurrences with shorter times and similar safety; leaves open confirmation in randomized trials.
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.
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Cui et al. (2020) studied this question.
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