| Background:We employed evidence-based medicine to evaluate the difference of safety and efficacy between second-generation cryoballoon(CB2)ablation and radiofrequency(RF)ablation for paroxysmal atrial fibrillation(PAF).Methods:We searched online databases including Chinese Biomedical Medical Literature(CBM),China Wan Fang,China National Knowledge Infrastructure(CNKI),VIP,PubMed,Web of Science and Cochrane Library.The clinical studies dating from inception to April 1th 2018 were taken into account.Data extraction,study selection and quality of evaluation were performed by two researchers.In the quality of evaluation,a modified Jadad scoring scale was used to evaluate the randomized controlled trail(RCT)study,and the Newcastle-Ottawa Scale(NOS)rating Scale recommended by the Cochrane non-random method group was used for non-RCT.RevMan 5.3 software provided by Cochrane collaboration was used for further statistic analyses.Finally,according to the results of I~2 test heterogeneity analysis,the effect models were selected.Results:A total of 6 clinical studies,with 948 patients,were included in this meta-analysis with 443 patients in CB2 group and 430 patients in RF group.The results of meta-analysis as follow:the CB2 ablation had a tendency to decrease procedure time[weighted mean difference(WMD)=﹣28.00,95%confidence interval(CI):﹣53.32—﹣2.69,P=0.03],a slightly higher total complication rate[odds ratio(OR)=1.85,95%CI:1.06—3.21,P=0.03]than the RF ablation,almost all the cases of phrenic nerve palsy(PNP)occurred in CB2 group.whereas non-PNP complications was seldom manifested in CB2 group[OR=0.27,95%CI:0.10—0.69,P=0.006],there was no statistically significant difference in the other safety and efficacy indexes.Conclusion:Compared with traditional RF,the efficacy and safety of CB2 ablation in the treatment of PAF were similar,and the operation time of CB2 ablation was significantly shortened. |
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