AUTHOR=Mao Zhi-Jie , Pei Yan , Lin Hui , Xiang Yin , Huang Zhou-Qing , Xiao Fang-Yi , Chen Yi-He 

TITLE=Assessment of High-Power Catheter Ablation in Patients With Atrial Fibrillation: A Meta-Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.609590

DOI=10.3389/fcvm.2021.609590

ISSN=2297-055X

ABSTRACT=Background 
High-power radiofrequency (RF) catheter ablation was considered as a promising alternative strategy to conventional-power ablation in the treatment of patients with atrial fibrillation (AF). This study sought to compare the efficacy and safety of high-power energy delivery to that of conventional-power setting in AF catheter ablation.
Methods 
We performed a systematic review of relevant literature in Pubmed, Embase, Cochrane library, and Google Scholar database. 16 eligible studies totaling 3,307 patients (1,929 for high-power ablation; 1,378 for conventional-power ablation) met inclusion criteria.
Results
During a median 12 months follow-up, high-power ablation showed a significantly higher AF/atrial tachycardia free survival rate in comparison with conventional-power ablation (risk ratio [RR] 1.09, 95% CI 1.02 to 1.15, P = 0.008). Notably, high-power strategy convincingly decreased the procedure time (weighted mean difference [WMD] -46.11 min, 95% CI -59.15 to -33.07, P < 0.001) and RF ablation time (WMD -19.19 min, 95% CI -24.47 to -13.90, P < 0.001), along with reduced fluoroscopy time (WMD -7.82 min, 95% CI -15.13 to -0.68, P = 0.036). In addition, there was no perceptible difference in the potential risk of procedure-related complications between these two approaches (RR 0.81, 95% CI 0.48 to 1.37, P = 0.428).
Conclusions
High-power RF catheter ablation was associated with an improvement in long-term sinus rhythm maintenance for treatment of AF, without exacerbating the risk of adverse events during the procedure. Impressively, high-power pulmonary vein isolation had the potential to shorten application duration and minimize fluoroscopic exposure.