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SYSTEMATIC REVIEW article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1364893
This article is part of the Research Topic Atrial Fibrillation: Selection of Management Strategy and Evaluation of Outcomes View all 38 articles

The safety and efficacy of third-and fourth-generation cryoballoon for atrial fibrillation: a systematic review and meta-analysis

Provisionally accepted
Man-Li Zhang Man-Li Zhang 1Chao Zhang Chao Zhang 1Jian-Yong Peng Jian-Yong Peng 1Xing Shuqiao Xing Shuqiao 2Jian Guo Jian Guo 1Chen-Long Wei Chen-Long Wei 1Neng-Fang Zhang Neng-Fang Zhang 1En Ma En Ma 1Wen-Sheng Chen Wen-Sheng Chen 1*
  • 1 Xi'an Gaoxin Hospital, Xi'an, China
  • 2 Hangzhou Normal University, Hangzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    Objectives: Increasing studies showed third-(CB3) and fourth-generation cryoballoon (CB4) were used to treat various types of atrial fibrillation (AF), but previous studies regarding the safety and efficacy of CB3 or CB4 ablation remained controversial conclusions. Therefore, a meta-analysis was performed to further evaluate the safety and efficacy of PVI using CB3 and CB4 in the treatment of AF.Methods: We searched PubMed, Cochrane Library, web of science, CNKI, Wanfang, VIP and Clinicaltrials.gov database up to Dec 2023 for qualified trials and data extraction according to inclusion and exclusion criteria. All analyses were carried out using the Review Manager 5.3 software.Results: Eventually, the meta-analysis included 13 observational studies consisting of 3281 subjects, and did not include a randomized controlled trial. Overall analyses indicated that CB3 significantly reduced total procedure time (WMD = -8.69 min, 95% CI=-15.45~-1.94 min, I 2 =93%), increased the PVI recording (RR=1.24, 95% CI= 1.03~1.49, I 2 =90%), and increased the mean nadir temperature of overall PVs (WMD =2.80 ℃, 95% CI=1.08~4.51 ℃, I 2 =89%) compared with CB2. Moreover, CB4 significantly reduced total procedure time (WMD = -14.50 min, 95% CI=-20.89~-8.11 min, I 2 =95%), reduced fluoroscopy time (WMD =-2.37 min, 95% CI=-4.28~-0.46 min, I 2 =95%), increased the PVI recording (RR=1.40, 95% CI=1.15~1.71, I 2 =90%), and increased the compared with CB2, respectively. Whereas time-to-isolation, success rate of PVI, AF recurrence and complication in CB3 and CB4 were not significant difference compared with CB2.These findings demonstrated that CB3 and CB4 tended to be more effective than CB2 in the treatment of AF, both with shorter procedure time, more PVI recording and similar safety endpoints.

    Keywords: Atrial Fibrillation, third-generation cryoballoon, fourth-generation cryoballoon, Safety and efficacy, Meta-analysis

    Received: 03 Jan 2024; Accepted: 22 Jul 2024.

    Copyright: © 2024 Zhang, Zhang, Peng, Shuqiao, Guo, Wei, Zhang, Ma and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wen-Sheng Chen, Xi'an Gaoxin Hospital, Xi'an, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.