Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta‐analysis

Abstract Introduction Endocardial catheter ablation (ECA) for atrial fibrillation (AF) has limited efficacy. Hybrid convergent procedure (HCP) with both epicardial and endocardial ablation is a novel strategy for AF treatment. In this meta‐analysis, we aimed to evaluate the efficacy and safety of HC...

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Autores principales:	Mohammed Mhanna, Azizullah Beran, Ahmad Al‐Abdouh, Hazem Ayesh, Omar Sajdeya, Omar Srour, Mahmoud Alsaiqali, Odai H. Alhasanat, Cameron Burmeister, Abdelrhman M. Abumoawad, Paul Chacko
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	ablation atrial fibrillation endocardial epicardial hybrid Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/f8c77fec837a4366ad934ef353c80955
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spelling	oai:doaj.org-article:f8c77fec837a4366ad934ef353c809552021-12-02T08:25:11ZHybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta‐analysis1883-21481880-427610.1002/joa3.12653https://doaj.org/article/f8c77fec837a4366ad934ef353c809552021-12-01T00:00:00Zhttps://doi.org/10.1002/joa3.12653https://doaj.org/toc/1880-4276https://doaj.org/toc/1883-2148Abstract Introduction Endocardial catheter ablation (ECA) for atrial fibrillation (AF) has limited efficacy. Hybrid convergent procedure (HCP) with both epicardial and endocardial ablation is a novel strategy for AF treatment. In this meta‐analysis, we aimed to evaluate the efficacy and safety of HCP in AF ablation. Method We performed a comprehensive literature search for studies that evaluated the efficacy and safety of HCP compared with ECA for AF. The primary outcome was freedom of atrial arrhythmia (AA). The secondary outcome was the periprocedural complication rate. Pooled relative risk (RR) and corresponding 95% confidence intervals (CIs) were calculated using the random effects model. Results A total of eight studies, including 797 AF patients (mean age: 60.7 ± 9.8 years, 366 patients with HCP vs. 431 patients with ECA alone), were included. HCP showed a higher rate of freedom of AA compared with ECA (RR: 1.48, 95% CI: 1.13–1.94, p = .004). However, HCP was associated with higher rates of periprocedural complications (RR: 3.64, 95% CI: 2.06–6.43; p = .00001). Moreover, the HCP had a longer procedure time and postprocedural hospital stay. Conclusions Although hybrid ablation was associated with a higher success rate, this should be judged for increased periprocedural adverse events and extended hospital stay. Prospective large‐scale randomized trials are needed to validate these results.Mohammed MhannaAzizullah BeranAhmad Al‐AbdouhHazem AyeshOmar SajdeyaOmar SrourMahmoud AlsaiqaliOdai H. AlhasanatCameron BurmeisterAbdelrhman M. AbumoawadPaul ChackoWileyarticleablationatrial fibrillationendocardialepicardialhybridDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Arrhythmia, Vol 37, Iss 6, Pp 1459-1467 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ablation atrial fibrillation endocardial epicardial hybrid Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	ablation atrial fibrillation endocardial epicardial hybrid Diseases of the circulatory (Cardiovascular) system RC666-701 Mohammed Mhanna Azizullah Beran Ahmad Al‐Abdouh Hazem Ayesh Omar Sajdeya Omar Srour Mahmoud Alsaiqali Odai H. Alhasanat Cameron Burmeister Abdelrhman M. Abumoawad Paul Chacko Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta‐analysis
description	Abstract Introduction Endocardial catheter ablation (ECA) for atrial fibrillation (AF) has limited efficacy. Hybrid convergent procedure (HCP) with both epicardial and endocardial ablation is a novel strategy for AF treatment. In this meta‐analysis, we aimed to evaluate the efficacy and safety of HCP in AF ablation. Method We performed a comprehensive literature search for studies that evaluated the efficacy and safety of HCP compared with ECA for AF. The primary outcome was freedom of atrial arrhythmia (AA). The secondary outcome was the periprocedural complication rate. Pooled relative risk (RR) and corresponding 95% confidence intervals (CIs) were calculated using the random effects model. Results A total of eight studies, including 797 AF patients (mean age: 60.7 ± 9.8 years, 366 patients with HCP vs. 431 patients with ECA alone), were included. HCP showed a higher rate of freedom of AA compared with ECA (RR: 1.48, 95% CI: 1.13–1.94, p = .004). However, HCP was associated with higher rates of periprocedural complications (RR: 3.64, 95% CI: 2.06–6.43; p = .00001). Moreover, the HCP had a longer procedure time and postprocedural hospital stay. Conclusions Although hybrid ablation was associated with a higher success rate, this should be judged for increased periprocedural adverse events and extended hospital stay. Prospective large‐scale randomized trials are needed to validate these results.
format	article
author	Mohammed Mhanna Azizullah Beran Ahmad Al‐Abdouh Hazem Ayesh Omar Sajdeya Omar Srour Mahmoud Alsaiqali Odai H. Alhasanat Cameron Burmeister Abdelrhman M. Abumoawad Paul Chacko
author_facet	Mohammed Mhanna Azizullah Beran Ahmad Al‐Abdouh Hazem Ayesh Omar Sajdeya Omar Srour Mahmoud Alsaiqali Odai H. Alhasanat Cameron Burmeister Abdelrhman M. Abumoawad Paul Chacko
author_sort	Mohammed Mhanna
title	Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta‐analysis
title_short	Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta‐analysis
title_full	Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta‐analysis
title_fullStr	Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta‐analysis
title_full_unstemmed	Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta‐analysis
title_sort	hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: a systematic review and meta‐analysis
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/f8c77fec837a4366ad934ef353c80955
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_version_	1718398580770734080

Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta‐analysis

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