Impact of image integration on clinical and procedural outcomes of radiofrequency catheter ablation of atrial fibrillation: A meta-analysis of randomized controlled trials

Background: The purpose of this meta-analysis was to evaluate the impact of image integration technique on clinical and procedural outcomes in patients undergoing radiofrequency catheter ablation of atrial fibrillation with a three-dimensional electroanatomic mapping system.

Methods: Randomized controlled trials were identified through a systematic literature search of PubMed and CENTRAL databases from inception to April 2020. The primary outcome was arrhythmia recurrence during the follow-up period. The secondary outcomes were the difference in total procedural time and fluoroscopy time.

Results: Four studies with a total of 749 patients were included. The pooled result showed no statistically significant difference between the groups with respect to arrhythmia recurrence (RR, 0.75; 95% CI, 0.47-1.21), fluoroscopy time (MD, -6 minutes; 95% CI, -23.4 to 11.3), and total procedural time (MD, 1.1 minutes; 95% CI, -31.8 to 34.1).

Conclusion: Image integration to guide radiofrequency catheter ablation for patients with atrial fibrillation does not improve clinical and procedural outcomes.