title: Use of contact force sensing technology during radiofrequency ablation reduces recurrence of atrial fibrillation: A systematic review and meta-analysis.
abstract: The suboptimal outcomes of atrial fibrillation (AF) ablation have been attributed to lack of transmural lesions during pulmonary vein isolation. The advent of contact force (CF) sensing technology enables real-time assessment of the applied force at the catheter-tissue interface and increases the chances of transmural lesions. We sought to perform a meta-analysis of data from eligible studies to delineate the true impact of CF technology. Database searches through April 2015 identified 9 eligible studies (enrolling 1148 patients). The relative risk of AF recurrence at follow-up was used as the primary end point and assessed with random-effects meta-analysis. Radiofrequency (RF) duration, total procedure length, and fluoroscopy exposure were assessed as secondary outcomes using weighted mean difference with the random-effects model. Compared with standard technology, the use of CF technology showed a 37% reduction (relative risk 0.63; 95% confidence interval 0.44-0.91; P = .01) in AF recurrence at a median follow-up of 12 months and a 7.3-minute reduction (95% confidence interval -14.05 to -0.55; P = .03) in RF use during ablation. There was no significant difference in total procedure length and fluoroscopy exposure between the 2 groups. In conclusion, this meta-analysis shows that the use of CF technology decreases AF recurrence at a median follow-up of 12 months and also led to decreased use of RF during ablation. There was no difference in total procedure length and fluoroscopy exposure.
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Muhammad R
authors.initials: MR
authors.lastname: Afzal
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Jawaria
authors.initials: J
authors.lastname: Chatta
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Anweshan
authors.initials: A
authors.lastname: Samanta
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Salman
authors.initials: S
authors.lastname: Waheed
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Morteza
authors.initials: M
authors.lastname: Mahmoudi
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Rachel
authors.initials: R
authors.lastname: Vukas
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Sampath
authors.initials: S
authors.lastname: Gunda
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Madhu
authors.initials: M
authors.lastname: Reddy
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Buddhadeb
authors.initials: B
authors.lastname: Dawn
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City, Kansas. Electronic address: dlakkireddy@kumc.edu.
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003935:Diagnostic Techniques, Cardiovascular; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D012008:Recurrence; D015203:Reproducibility of Results
keywords: Atrial fibrillation; Contact force sensing technology; Meta-analysis; Pulmonary vein isolation; Radiofrequency ablation