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- Title
Comparison of the Efficacy of Cooled-Tip and 8-mm-Tip Catheters for Radiofrequency Catheter Ablation of the Cavotricuspid Isthmus: A Meta-Analysis.
- Authors
DA COSTA, ANTOINE; CUCHERAT, MICHEL; PICHON, NATHALIE; MESSIER, MARC; LAPORTE, SYLVIE; ROMÉYER‐BOUCHARD, CÉCILE; MISMETTI, PATRICK; LOPEZ, MICHEL; ISAAZ, KARL
- Abstract
Background: Cooled-tip RFA (cRFA) and conventional 8-mm-tip catheters were found to be more effective and as safe as conventional 4-mm-tip catheters for atrial flutter (AFL) radiofrequency ablation (RFA), facilitating the rapid achievement of bi-directional isthmus block (BIB), but studies comparing cRFA and 8-mm-tip catheters are not randomized or results are discussed. Thus, we performed a meta-analysis of available randomized trials to evaluate the effectiveness in terms of primary success and procedure parameters. Methods: Reports of trials were identified through a Medline, Embase, Current Contents, Cardline, and an extensive bibliography search. Trials that met the following criteria were included: (1) prospective, randomized, controlled, and open trials; (2) patients assigned to an 8-mm-tip or a cRFA catheter for AFL RFA; (3) endpoints events related to primary success rate (BIB achievement), and procedure parameters (number of RF applications, x-ray exposure and ablation duration). Results: Seven trials met the inclusion criteria. They included 603 patients with established AFL randomized to an 8-mm-tip or cRFA catheter group. Comparing 8-mm groups with cRFA groups, the meta-analysis showed similar BIB achievement relative risk (RR) 0.96, 95% confidence interval (CI): 0.92 to 1.01, (P = 0.13); total RF application time weighted mean difference (WMD) 0.88, 95% CI: −0.36 to 2.12, (P = 0.16); duration of x-ray exposure (min) (WMD = 1.07, 95% CI: −0.81 to 0.295, (P = 0.26); ablation procedure duration (min) (WMD = 0.68, 95% CI: −3.37 to 4.73; P = 0.74). Conclusion: The present meta-analysis confirms that cooled-tip and large-tip catheters are equally efficient for cavotricuspid isthmus ablation with both similar primary success rates and procedure parameters.
- Subjects
CATHETER ablation; CATHETERS; ATRIAL flutter; CLINICAL trials; META-analysis
- Publication
Pacing & Clinical Electrophysiology, 2005, Vol 28, Issue 10, p1081
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.2005.00231.x