Second-generation cryoballoon vs. contact-force sensing radiofrequency catheter ablation in atrial fibrillation: a meta-

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Second-generation cryoballoon vs. contact-force sensing radiofrequency catheter ablation in atrial fibrillation: a meta-analysis of randomized controlled trials Yang Wang 1 & Wei Wang 2,3 & Jianming Yao 4 & Lianghua Chen 2 & Shaolei Yi 2,3 Received: 22 May 2020 / Accepted: 29 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Objectives It is imperative to understand the influence of second-generation cryoballoon (CB-2) and contact-force sensing radiofrequency ablation (CF-RF) on clinical outcomes in atrial fibrillation (AF). This updated meta-analysis of randomized controlled trials (RCTs) examined the efficacy and safety of CB-2 vs. CF-RF in patients with AF. Methods RCTs on the use of CB-2 vs. CF-RF in patients with AF were included. The primary outcome was the recurrence of AF, and the key secondary outcomes included serious complications, acute pulmonary vein isolation (PVI), procedure duration, and fluoroscopy time. Results A total of 261 articles were identified, and five studies with a total of 845 participants were included in the study. A total of 93% of participants had paroxysmal AF, 7% of participants had persistent AF, and none of participants had permanent AF. There were 499 participants in the CB-2 arm and 346 in the CF-RF arm. AF recurrence was comparable in the CB-2 group (30.3%) and the CF-RF group (29.2%) (OR = 0.93; 95%CI = 0.56–1.54; P = 0.79; I2 = 48%). There were no statistical differences in acute PVI (P = 0.92; I2 = 0%) and serious complications (P = 0.87; I2 = 47%) between the two groups. The procedure duration was shorter in the CB-2 group than in the CF-RF group (MD = − 13.39; 95%CI = − 15.58, − 7.19; P < 0.0001; I2 = 59%). Conclusion Our study demonstrated that CB-2 and CF-RF had comparable recurrences of AF and similar incidences of serious complications in AF patients during the ablation process. Keywords Atrial fibrillation . Catheter ablation . Second-generation cryoballoon . Contact-force sensing radiofrequency

Wei Wang is the co-first author Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10840-020-00893-w) contains supplementary material, which is available to authorized users. * Shaolei Yi [email protected] Wei Wang [email protected] 1

Department of Radiation Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China

2

Department of Cardiology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China

3

Department of Cardiology, Shandong Provincial Hospital affiliated to Shandong University, 324 Jingwulu, Jinan 250010, Shandong Province, China

4

Department of Cardiology, Jinan Municipal Hospital of Traditional Chinese Medicine, Jinan, China

1 Introduction Catheter ablation has been proven to be an effective therapeutic method for restoring and maintaining sinus rhythm in patients with atrial fibrillation (AF) [1, 2]. Pulmonary vein isolation (PVI) is the cornerstone of catheter-based treatment for AF [3], and