Silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon, hotballoon, laserballoon and radiofrequency catheters: a Bayesian network meta-analysis
BackgroundCatheter ablation (CA) is an effective therapeutic option for patients with symptomatic atrial fibrillation (AF). Previous studies have reported silent cerebral lesions (SCLs) detected by magnetic resonance imaging (MRI) after different CA techniques; however, the results were controversia...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1510468/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841540137325953024 |
|---|---|
| author | Tiantian Zheng Youjin Kong Li Wu Chenxia Wu Chenxia Wu Wei Mao Wei Mao Xinbin Zhou Xinbin Zhou |
| author_facet | Tiantian Zheng Youjin Kong Li Wu Chenxia Wu Chenxia Wu Wei Mao Wei Mao Xinbin Zhou Xinbin Zhou |
| author_sort | Tiantian Zheng |
| collection | DOAJ |
| description | BackgroundCatheter ablation (CA) is an effective therapeutic option for patients with symptomatic atrial fibrillation (AF). Previous studies have reported silent cerebral lesions (SCLs) detected by magnetic resonance imaging (MRI) after different CA techniques; however, the results were controversial. Therefore, we performed this network meta-analysis (NMA) to assess the incidence of SCLs after cryoballoon, hotballoon, laserballoon, and radiofrequency ablation (RFA).MethodsDatabases such as PubMed, Embase, and the Cochrane Library were searched systematically. Both pairwise meta-analysis (PMA) and NMA were conducted. The primary outcome was the incidence of new SCLs on MRI after CA procedures.ResultsNine studies were analyzed and 1,057 patients were enrolled. Laserballoon ablation (LBA) had a higher incidence of SCLs than cryoballoon ablation (CBA) [odds ratio [OR] = 1.86, 95% confidence interval [CI] 1.06–3.27, p = 0.032] in the PMA, while no significant difference was detected between the CA techniques according to the NMA. The surface under the cumulative ranking curve (SUCRA) values indicated that CBA may be the best therapeutic option (SUCRA = 81.1%). The NMA results demonstrated similar procedure-related complication rates and mean activated clotting time between CBA (SUCRA = 53.7%, 66.3%), hotballoon ablation (HBA) (SUCRA = 81.5%, 43.6%), LBA (SUCRA = 3.39%, 42.8%) and RFA (SUCRA = 61.3%, 47.3%). LBA therapy required significantly more procedure time than CBA [weighted mean difference (WMD) = 24.36 min, 95% CI 12.51–36.21 min, p = 0.00].ConclusionsCBA treatment had lower incidence of post-procedural SCLs and took less procedure time compared with LBA for patients with AF. The procedure-related complications were comparable between CBA, LBA, HBA and RFA.Systematic Review RegistrationPROSPERO, identifier (CRD42024511110). |
| format | Article |
| id | doaj-art-9b6e8a8c68d54460a203ab4f2ad51d3f |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-9b6e8a8c68d54460a203ab4f2ad51d3f2025-01-14T06:10:41ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.15104681510468Silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon, hotballoon, laserballoon and radiofrequency catheters: a Bayesian network meta-analysisTiantian Zheng0Youjin Kong1Li Wu2Chenxia Wu3Chenxia Wu4Wei Mao5Wei Mao6Xinbin Zhou7Xinbin Zhou8Department of Cardiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, ChinaDepartment of Cardiology, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaZhejiang Key Laboratory of Integrative Chinese and Western Medicine for Diagnosis and Treatment of Circulatory Diseases, Hangzhou, ChinaDepartment of Cardiology, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaZhejiang Key Laboratory of Integrative Chinese and Western Medicine for Diagnosis and Treatment of Circulatory Diseases, Hangzhou, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, ChinaZhejiang Key Laboratory of Integrative Chinese and Western Medicine for Diagnosis and Treatment of Circulatory Diseases, Hangzhou, ChinaBackgroundCatheter ablation (CA) is an effective therapeutic option for patients with symptomatic atrial fibrillation (AF). Previous studies have reported silent cerebral lesions (SCLs) detected by magnetic resonance imaging (MRI) after different CA techniques; however, the results were controversial. Therefore, we performed this network meta-analysis (NMA) to assess the incidence of SCLs after cryoballoon, hotballoon, laserballoon, and radiofrequency ablation (RFA).MethodsDatabases such as PubMed, Embase, and the Cochrane Library were searched systematically. Both pairwise meta-analysis (PMA) and NMA were conducted. The primary outcome was the incidence of new SCLs on MRI after CA procedures.ResultsNine studies were analyzed and 1,057 patients were enrolled. Laserballoon ablation (LBA) had a higher incidence of SCLs than cryoballoon ablation (CBA) [odds ratio [OR] = 1.86, 95% confidence interval [CI] 1.06–3.27, p = 0.032] in the PMA, while no significant difference was detected between the CA techniques according to the NMA. The surface under the cumulative ranking curve (SUCRA) values indicated that CBA may be the best therapeutic option (SUCRA = 81.1%). The NMA results demonstrated similar procedure-related complication rates and mean activated clotting time between CBA (SUCRA = 53.7%, 66.3%), hotballoon ablation (HBA) (SUCRA = 81.5%, 43.6%), LBA (SUCRA = 3.39%, 42.8%) and RFA (SUCRA = 61.3%, 47.3%). LBA therapy required significantly more procedure time than CBA [weighted mean difference (WMD) = 24.36 min, 95% CI 12.51–36.21 min, p = 0.00].ConclusionsCBA treatment had lower incidence of post-procedural SCLs and took less procedure time compared with LBA for patients with AF. The procedure-related complications were comparable between CBA, LBA, HBA and RFA.Systematic Review RegistrationPROSPERO, identifier (CRD42024511110).https://www.frontiersin.org/articles/10.3389/fcvm.2024.1510468/fullatrial fibrillationsilent cerebral lesionscryoballoon ablationhotballoon ablationlaserballoon ablationradiofrequency ablation |
| spellingShingle | Tiantian Zheng Youjin Kong Li Wu Chenxia Wu Chenxia Wu Wei Mao Wei Mao Xinbin Zhou Xinbin Zhou Silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon, hotballoon, laserballoon and radiofrequency catheters: a Bayesian network meta-analysis Frontiers in Cardiovascular Medicine atrial fibrillation silent cerebral lesions cryoballoon ablation hotballoon ablation laserballoon ablation radiofrequency ablation |
| title | Silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon, hotballoon, laserballoon and radiofrequency catheters: a Bayesian network meta-analysis |
| title_full | Silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon, hotballoon, laserballoon and radiofrequency catheters: a Bayesian network meta-analysis |
| title_fullStr | Silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon, hotballoon, laserballoon and radiofrequency catheters: a Bayesian network meta-analysis |
| title_full_unstemmed | Silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon, hotballoon, laserballoon and radiofrequency catheters: a Bayesian network meta-analysis |
| title_short | Silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon, hotballoon, laserballoon and radiofrequency catheters: a Bayesian network meta-analysis |
| title_sort | silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon hotballoon laserballoon and radiofrequency catheters a bayesian network meta analysis |
| topic | atrial fibrillation silent cerebral lesions cryoballoon ablation hotballoon ablation laserballoon ablation radiofrequency ablation |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1510468/full |
| work_keys_str_mv | AT tiantianzheng silentcerebrallesionsaftercatheterablationforatrialfibrillationusingcryoballoonhotballoonlaserballoonandradiofrequencycathetersabayesiannetworkmetaanalysis AT youjinkong silentcerebrallesionsaftercatheterablationforatrialfibrillationusingcryoballoonhotballoonlaserballoonandradiofrequencycathetersabayesiannetworkmetaanalysis AT liwu silentcerebrallesionsaftercatheterablationforatrialfibrillationusingcryoballoonhotballoonlaserballoonandradiofrequencycathetersabayesiannetworkmetaanalysis AT chenxiawu silentcerebrallesionsaftercatheterablationforatrialfibrillationusingcryoballoonhotballoonlaserballoonandradiofrequencycathetersabayesiannetworkmetaanalysis AT chenxiawu silentcerebrallesionsaftercatheterablationforatrialfibrillationusingcryoballoonhotballoonlaserballoonandradiofrequencycathetersabayesiannetworkmetaanalysis AT weimao silentcerebrallesionsaftercatheterablationforatrialfibrillationusingcryoballoonhotballoonlaserballoonandradiofrequencycathetersabayesiannetworkmetaanalysis AT weimao silentcerebrallesionsaftercatheterablationforatrialfibrillationusingcryoballoonhotballoonlaserballoonandradiofrequencycathetersabayesiannetworkmetaanalysis AT xinbinzhou silentcerebrallesionsaftercatheterablationforatrialfibrillationusingcryoballoonhotballoonlaserballoonandradiofrequencycathetersabayesiannetworkmetaanalysis AT xinbinzhou silentcerebrallesionsaftercatheterablationforatrialfibrillationusingcryoballoonhotballoonlaserballoonandradiofrequencycathetersabayesiannetworkmetaanalysis |