两代冷冻球囊心房颤动导管消融疗效及安全性对比的Meta分析

Efficacy and safety of two generations of cryoballoon in catheter ablation of atrial fibrillation: A Meta-analysis

目的 探讨第一代冷冻球囊与第二代冷冻球囊导管消融治疗房颤的疗效及安全性。方法 计算机检索The Cochrane Library、Pubmed、EMBASE、中国知网、万方等数据库关于两代冷冻球囊导管消融疗效及安全对比的文献，根据纳入及排除标准，对符合要求的文献进行质量评价，提取数据，对两代球囊关于肺静脉电隔离成功率、膈神经麻痹发生率、手术时间、曝光时间、3月及1年无复发率等采用RevMan 5.0软件进行Meta分析。结果 共纳入8篇文献（共2094名患者），Meta分析结果显示两代冷冻球囊肺静脉电隔离成功率没有统计学差异（RR=0.99，95％CI：0.99～1.00，P=0.03），手术时间、曝光时间、3月及1年无复发率优于第一代冷冻球囊，而膈神经麻痹发生率却高于第一代球囊（RR=0.57，95％CI：0.41～0.80，P＜0.05）。结论 第二代球囊能带来更好的手术疗效，而膈神经麻痹却高于第一代球囊。

Objective To explore the efficacy and safety of two generations of cryoballoon catheter ablationin the treatment of atrial fibrillation. Methods Articles were searched and identified from the Cochrane Library,PubMed, EMBASE and CNKI about two generations cryoballoon. Literatures were included according to inclusionand exclusion criteria following quality assessment and data extraction. Meta-analyses were performed by RevMan5.0 about the success rate of pulmonary vein isolation, the incidence of phrenic nerve palsy, the relapse-free rateof 3 months, the relapse-free rate of 1 year, duration of procedure, and time of fluoroscopy exposure. Results 8articles (2094 patients) were included. The results showed that between two generations of cryoballoon the successrate of pulmonary vein isolation has no difference (RR=0.99, 95%CI:0.99~1.00, P=0.03). The second generationis better than the first generation with respect to the relapse-free rate of 3 months, the relapse-free rate of 1 year.duration of procedure, and time of fluoroscopy exposure, but the incidence of phrenic nerve palsy is higher than thefirst generation (RR=0.57, 95%CI:0.41~0.80, P<0.05). Conclusion The second generation of cryoballoon ismore efficiency than the first generation, but the incidence of phrenic nerve palsy is higher than the first generation.