title: Impact of Contact Force Technology on Atrial Fibrillation Ablation: A Meta-Analysis.
abstract: BACKGROUND
  Catheter-tissue contact is essential for effective lesion formation, thus there is growing usage of contact force (CF) technology in atrial fibrillation ablation. We conducted a meta-analysis to assess the impact of CF on clinical outcomes and procedural parameters in comparison to conventional catheter for atrial fibrillation ablation.
  
  
  RESULTS
  An electronic search was performed using major databases. Outcomes of interest were recurrence rate, major complications, total procedure, and fluoroscopic times. Continuous variables were reported as standardized mean difference; odds ratios were reported for dichotomous variables. Eleven studies (2 randomized controlled studies and 9 cohorts) involving 1428 adult patients were identified. CF was deployed in 552 patients. The range of CF used was between 2 to 60 gram-force. The follow-up period ranged between 10 and 53 weeks. In comparing CF and conventional catheter groups, the recurrence rate was lower with CF (35.1% versus 45.5%, odds ratio 0.62 [95% CI 0.45-0.86], P=0.004). Shorter procedure and fluoroscopic times were achieved with CF (procedure time: 156 versus 173 minutes, standardized mean difference -0.85 [95% CI -1.48 to -0.21], P=0.009; fluoroscopic time: 28 versus 36 minutes, standardized mean difference -0.94 [95% CI -1.66; -0.21], P=0.01). Major complication rate was lower numerically in the CF group but not statistically significant (1.3% versus 1.9%, odds ratio 0.71 [95% CI 0.29-1.73], P=0.45).
  
  
  CONCLUSIONS
  The use of CF technology results in significant reduction of the atrial fibrillation recurrence rate after atrial fibrillation ablation in comparison to the conventional catheter group. CF technology is able to significantly reduce procedure and fluoroscopic times without compromising complication rate.
authors.affiliation: Arrhythmia Services, Cardiology Department, An-Najah National University Hospital, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine (M.S., S.H.Y.) Arrhythmia Services, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (M.S., A.K., D.N., I.L., E.C.).
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shurrab
authors.affiliation: Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY (L.D.B., D.F.B.) Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX (L.D.B.) Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B.) Department of Cardiology, University of Foggia, Italy (L.D.B.).
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.affiliation: Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY (L.D.B., D.F.B.).
authors.forename: David F
authors.initials: DF
authors.lastname: Briceno
authors.affiliation: Arrhythmia Services, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (M.S., A.K., D.N., I.L., E.C.).
authors.forename: Anna
authors.initials: A
authors.lastname: Kaoutskaia
authors.affiliation: Arrhythmia Services, Cardiology Department, An-Najah National University Hospital, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine (M.S., S.H.Y.) Institute of Cardiovascular and Medical Sciences, The University of Glasgow, Scotland, UK (S.H.Y.).
authors.forename: Saleem
authors.initials: S
authors.lastname: Haj-Yahia
authors.affiliation: Arrhythmia Services, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (M.S., A.K., D.N., I.L., E.C.).
authors.forename: David
authors.initials: D
authors.lastname: Newman
authors.affiliation: Arrhythmia Services, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (M.S., A.K., D.N., I.L., E.C.).
authors.forename: Ilan
authors.initials: I
authors.lastname: Lashevsky
authors.affiliation: Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK (H.N.).
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakagawa
authors.affiliation: Arrhythmia Services, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (M.S., A.K., D.N., I.L., E.C.).
authors.forename: Eugene
authors.initials: E
authors.lastname: Crystal
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D062906:Cardiac Catheters; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016009:Chi-Square Distribution; D004867:Equipment Design; D006801:Humans; D016017:Odds Ratio; D061646:Operative Time; D011829:Radiation Dosage; D015641:Radiography, Interventional; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: ablation; atrial fibrillation; contact force; meta‐analysis