Temperature-controlled Ablation Versus Conventional Ablation for Pulmonary Vein Isolation in the Treatment of AF: A Systematic Review and Meta-Analysis

Clay, Benjamin; Sokhal, Balamrit S; Zeriouh, Sarah; Srinivasan, Neil T; Gajendragadkar, Parag R; Martin, Claire A

Abstract

Background: This study compared the efficacy and safety of temperature-controlled and conventional contact-force-sensing radiofrequency ablation catheters for pulmonary vein isolation (PVI) in AF. Methods: Seven studies (1,138 patients) were included. Randomised controlled trials and observational (single-arm and two-arm) studies that reported freedom from AF ≥3 months after PVI with temperature-controlled radiofrequency ablation catheters (Biosense Webster QDOT MICRO operating in QMODE or Medtronic DiamondTemp) were included. Results: Freedom from AF at a mean (± SD) follow-up of 9.0 ± 3.6 months did not differ significantly between temperature-controlled and conventional ablation (OR 1.22; 95% CI [−0.79, 1.64]; p=0.24). Total procedure duration (−13.5 minutes; 95% CI [−17.1, −10.0 minutes]; p<0.001) and total ablation duration (−8.9 min; 95% CI [−10.3, −7.5 min]; p<0.01) were significantly shorter for temperature-controlled ablation. There were no significant differences between temperature-controlled and conventional ablation in either the aggregated rates of procedural complications (OR 0.69; 95% CI [−0.15, 1.54]; p=0.11) or in the rate of any individual complication. Conclusion: Temperature-controlled ablation was found to be at least non-inferior to conventional ablation in all measures of efficacy and safety. Further randomised controlled trials are warranted to evaluate long-term rates of freedom from AF and patient comfort.

Citation

Clay, B., Sokhal, B. S., Zeriouh, S., Srinivasan, N. T., Gajendragadkar, P. R., & Martin, C. A. (2025). Temperature-controlled Ablation Versus Conventional Ablation for Pulmonary Vein Isolation in the Treatment of AF: A Systematic Review and Meta-Analysis. Arrhythmia and Electrophysiology Review, 14, https://doi.org/10.15420/aer.2024.41

• Journal Article Type: Article
• Acceptance Date: Oct 9, 2024
• Online Publication Date: Jan 30, 2025
• Publication Date: Jan 30, 2025
• Deposit Date: Feb 17, 2025
• Journal: Arrhythmia & Electrophysiology Review
• Print ISSN: 2050-3369
• Electronic ISSN: 2050-3377
• Publisher: Radcliffe Medical Media
• Peer Reviewed: Peer Reviewed
• Volume: 14
• DOI: https://doi.org/10.15420/aer.2024.41
• Keywords: AF, catheter ablation, radiofrequency, temperature-controlled, pulmonary vein isolation
• Public URL: https://keele-repository.worktribe.com/output/1076644
• Publisher URL: https://www.aerjournal.com/articles/temperature-controlled-ablation-versus-conventional-ablation-pulmonary-vein-isolation