| Objective: To evaluate the efficacy and safety of laser balloon ablation in the treatment of atrial fibrillation.Methods: Pub Med and EMBASE were searched by computer to collect the randomized controlled trials and prospective cohort studies published before the end of November 2022 to evaluate the efficacy and safety of laser balloon ablation in the treatment of atrial fibrillation,and the effective information in the collected literatures was extracted for statistical processing and analysis.Results: A total of 10 English-language articles containing 1385 patients meeting the inclusion criteria,including 7 randomized controlled trials and 3 prospective cohort studies,were meta-analyzed using Rev Man5.3 software.The results showed that compared with radiofrequency ablation and cryoballoon ablation,the failure rate of pulmonary vein isolation by laser balloon ablation increased,but did not reach a statistically significant difference(Laser balloon ablation compared to radiofrequency ablation RR=2.25;95% CI: 0.98-5.13;P=0.06;Laser balloon ablation compared to cryoballoon ablation RR=1.81;95% CI: 0.97-3.37;P=0.06;),and there was no significant difference in the recurrence rate of postoperative atrial fibrillation(Laser balloon ablation compared to radiofrequency ablation RR=0.94;95% CI:0.75-1.18;P=0.60;Laser balloon ablation compared to cryoballoon ablation RR=0.95;95%CI:0.74-1.22;P=0.67;),there was no significant difference in the incidence of total postoperative adverse events(Laser balloon ablation compared to radiofrequency ablation RR=1.08;95% CI: 0.72-1.61;P=0.70;Laser balloon ablation compared to cryoballoon ablation RR=0.92;95% CI: 0.55-1.56;P=0.77;),among adverse events,compared with radiofrequency ablation,the incidence of phrenic nerve palsy by laser balloon ablation increased;Compared with cryoballoon ablation,there was a reduction in the rate of phrenic paralysis by laser balloon ablation,and there was no significant difference between them(Laser balloon ablation compared to radiofrequency ablation RR=5.00;95% CI: 0.88-28.55;P=0.07;Laser balloon ablation compared to cryoballoon ablation RR=0.43;95% CI: 0.17-1.10;P=0.08),and there was no significant difference in the incidence of cardiac tamponade(RR=1.26;95% CI: 0.34-4.64;P=0.73;),There was an increasing trend in the incidence of cerebral lesions,but there was no statistically significant difference(Laser balloon ablation compared to radiofrequency ablation RR=1.42;95% CI:0.66-3.02;P=0.37;Laser balloon ablation compared to cryoballoon ablation RR=1.46;95% CI:0.59-3.60;P=0.41).Conclusion: Compared with radiofrequency ablation and cryoballoon ablation,laser balloon ablation has similar efficacy and safety in the treatment of atrial fibrillation. |
