title: Impact of contact force technology on reducing the recurrence and major complications of atrial fibrillation ablation: A systematic review and meta-analysis.
abstract: Contact force (CF) monitoring can be useful in accomplishing circumferential pulmonary vein (PV) isolation for atrial fibrillation (AF). This meta-analysis aimed to assess the efficacy and safety of a CF-sensing catheter in treating AF. Randomized controlled trials or non-randomized observational studies comparing AF ablation using CF-sensing or standard non-CF (NCF)-sensing catheters were identified from PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure (January 1, 1998-2016). A total of 19 studies were included. The primary efficacy endpoint was AF recurrence within 12 months, which significantly improved using CF-sensing catheters compared with using NCF-sensing catheters [31.1% vs. 40.5%; risk ratio (RR)=0.82; 95% confidence interval (CI), 0.73-0.93; p<0.05]. Further, the acute PV reconnection (10.1% vs. 24.2%; RR=0.45; 95% CI, 0.32-0.63; p<0.05) and incidence of major complications (1.8% vs. 3.1%; OR=0.59; 95% CI, 0.37-0.95; p<0.05) significantly improved using CF-sensing catheters compared with using NCF-sensing catheters. Procedure parameters such as procedure duration [mean difference (MD)=-28.35; 95% CI, -39.54 to -17.16; p<0.05], ablation time (MD=-3.8; 95% CI, -6.6 to -1.0; p<0.05), fluoroscopy duration (MD=-8.18; 95% CI, -14.11 to -2.24; p<0.05), and radiation dose (standard MD=-0.75; 95% CI, -1.32 to -0.18; p<0.05] significantly reduced using CF-sensing catheters. CF-sensing catheter ablation of AF can reduce the incidence of major complications and generate better outcomes compared with NCF-sensing catheters during the 12-month follow-up period.
authors.forename: Xianhui
authors.initials: X
authors.lastname: Zhou
authors.forename: Wenkui
authors.initials: W
authors.lastname: Lv
authors.forename: Wenhui
authors.initials: W
authors.lastname: Zhang
authors.forename: Yuanzheng
authors.initials: Y
authors.lastname: Ye
authors.forename: Yaodong
authors.initials: Y
authors.lastname: Li
authors.forename: Qina
authors.initials: Q
authors.lastname: Zhou
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xing
authors.forename: Jianghua
authors.initials: J
authors.lastname: Zhang
authors.forename: Yanmei
authors.initials: Y
authors.lastname: Lu
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.forename: Hongli
authors.initials: H
authors.lastname: Wang
authors.forename: Wen
authors.initials: W
authors.lastname: Qin
authors.affiliation: Pacing and Electrophysiological Department, the First Affiliated Hospital of Xinjiang Medical University; Urumqi, Xinjiang-P. R. China. tangbaopeng1111@163.com.
authors.forename: Baopeng
authors.initials: B
authors.lastname: Tang
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation*; D002986:Clinical Trials as Topic; D006801:Humans; D011667:Pulmonary Veins