Intracardiac echography-guided fluoroless ablation versus conventional fluoroscopy-guided ablation for cardiac arrhythmias: a systematic review and meta-analysis
Lima, Ana Emanuela; Tenório, Gilson; Ferreira, André Luiz Carvalho; Gonzalez, Maria E. Benitez; Moreira, Matheus; Neves, Henrique Alexsander; Pasqualotto, Eric; Costa, Guilherme Morillos da; Guida, Camila Mota.
J. Am. Coll. Cardiol
; 83(13 Suppl. A)Apr. 2024. tab.
Artículo
en Inglés
| CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1551803
BACKGROUND:
Intracardiac echocardiography (ICE) has improved catheter ablation procedures, reducing reliance on fluoroscopy. Yet, the efficacy and safety of zero-fluoroscopy (ZF) procedures remain uncertain.METHODS:
We conducted a systematic review and meta-analysis comparing ZF ablation procedures guided by ICE vs. conventional techniques regarding efficacy and safety outcomes. PubMed, Cochrane, and embase were searched. A random-effects model was used to calculate risk ratios (RRs), odds ratios (OR) and mean differences (MDs) with 95% confidence intervals (CI).RESULTS:
We includedfourteen studies with 1,919 patients of whom 1,023 (58.72%) performed ZF ablation using ICE. We found a significant reduced ablation time (SMD -0.18; 95% CI -0.31;-0.04; p=0.009), procedure time (MD -7.54; 95% CI -14.68;-0.41; p=0.04), fluoroscopic time (MD -2.52; 95% CI -3.20;-1.84; p<0.001) in patients treated with ZF approach compared with NZF approach. However, there was no significant difference between the two groups in acute success rate (RR 1.00; 95% CI 0.99-1.01; p=0.85), long-term success rate (RR 0.99; 95% CI 0.93-1.05; p=0.77) and complications (RR 0.84, 95% CI 0.48-1.46; p = 0.54).CONCLUSION:
Our findings suggest that among patients undergoing arrhythmia ablation, fluoroscopy-free ICE-guided technique reduces procedure time and radiation exposure with comparable short and long-term success rates and complications.
Biblioteca responsable:
BR79.1
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