Skip to main content

SYSTEMATIC REVIEW article

Front. Cardiovasc. Med.
Sec. Cardioneurology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1510468
This article is part of the Research Topic Atrial Fibrillation's Impact on Cerebral Health and Dementia Risk View all articles

Silent cerebral lesions after catheter ablation for atrial fibrillation using cryoballoon, hotballoon, laserballoon and radiofrequency catheters: A Bayesian network meta-analysis

Provisionally accepted
Tiantian Zheng Tiantian Zheng 1Youjin Kong Youjin Kong 1Li Wu Li Wu 1Chenxia Wu Chenxia Wu 2Wei Mao Wei Mao 2Xinbin Zhou Xinbin Zhou 1*
  • 1 First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
  • 2 Zhejiang Hospital, Hangzhou, Zhejiang Province, China

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

    Background: Catheter ablation (CA) is an effective therapeutic option for patients with symptomatic atrial fibrillation (AF). Previous studies have reported silent cerebral lesions (SCLs) detected by magnetic resonance imaging (MRI) after different CA techniques; however, the results were controversial. Therefore, we performed this network meta-analysis (NMA) to assess the incidence of SCLs after cryoballoon, hotballoon, laserballoon, and radiofrequency ablation (RFA).Methods: Databases such as PubMed, Embase, and the Cochrane Library were searched systematically. Both pairwise meta-analysis (PMA) and NMA were conducted. The primary outcome was the incidence of new SCLs on MRI after CA procedures.Results: Nine studies were analyzed and 1057 patients were enrolled. Laserballoon ablation (LBA) had a higher incidence of SCLs than cryoballoon ablation (CBA) (odds ratio [OR] = 1.86, 95% confidence interval [CI] 1.06-3.27, p=0.032) in the PMA, while no significant difference was detected between the CA techniques according to the NMA. The surface under the cumulative ranking curve (SUCRA) values indicated that CBA may be the best therapeutic option (SUCRA = 81.1%). The NMA results demonstrated similar procedure-related complication rates and mean activated clotting time between CBA (SUCRA = 53.7%, 66.3%), hotballoon ablation (HBA) (SUCRA = 81.5%, 43.6%), LBA (SUCRA = 3.39%, 42.8%) and RFA (SUCRA = 61.3%, 47.3%).LBA therapy required significantly more procedure time than CBA (weighted mean difference [WMD] = 24.36 min, 95% CI 12.51-36.21 min, p = 0.00).Conclusions: CBA treatment had lower incidence of post-procedural SCLs and took less procedure time compared with LBA for patients with AF. The procedure-related complications were comparable between CBA, LBA, HBA and RFA.

    Keywords: Atrial Fibrillation, Silent cerebral lesions, Cryoballoon ablation, HotBalloon ablation, Laserballoon ablation, Radiofrequency ablation, Network meta-analysis

    Received: 13 Oct 2024; Accepted: 31 Dec 2024.

    Copyright: © 2024 Zheng, Kong, Wu, Wu, Mao and Zhou. 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: Xinbin Zhou, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, 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.