Comparative efficacy and safety of contact force-sensing catheter and second-generation cryoballoon ablation for atrial fibrillation: a meta-analysis.

Abstract This meta-analysis compared the efficacy and safety of the contact force (CF)-sensing catheter and second-generationcryoballoon (CB) ablation for treating atrial fibrillation (AF). Six controlled clinical trials comparing ablation for AF using aCF-sensing catheter or second-generation CB were identified from PubMed, EMBASE, Cochrane Library, Wanfang Data,and China National Knowledge Infrastructure. The procedure duration was significantly lower in the CB group comparedwith that in the CF group [mean difference (MD)=29.4; 95%CI=17.84–40.96; P=0.01], whereas there was no differencebetween the groups for fluoroscopy duration (MD=0.59; 95%CI=–4.48–5.66; P=0.82). Moreover, there was no difference inthe incidence of non-lethal complications (embolic event, tamponade, femoral/subclavian hematoma, arteriovenousfistula, pulmonary vein stenosis, phrenic nerve palsy, and esophageal injury) between the CB and the CF groups (8.38 vs5.35%; RR=0.66; 95%CI=0.37–1.17; P=0.15). Transient phrenic nerve palsy occurred in 17 of 326 patients (5.2%) ofthe CB group vs none in the CF group (RR=0.12; 95%CI=0.03–0.43; P=0.001). A comparable proportion of patients in CF andCB groups suffered from AF recurrence during the 12-month follow-up after a single ablation procedure [risk ratio (RR)=1.03;95%CI=0.78–1.35; P=0.84]. AF ablation using CF-sensing catheters and second-generation CB showed comparablefluoroscopy duration and efficacy (during a 12-month follow-up), with shorter procedure duration and different complications inthe CB group.Key words: Atrial fibrillation; Ablation; Contact force-sensing catheter; Second-generation cryoballoon; Meta-analysis