Comparing energy sources for surgical ablation of atrial fibrillation: a Bayesian network meta-analysis of randomized, controlled trials

Kevin Phan, Ashleigh Xie, Narendra Kumar, Sophia Wong, Caroline Medi, Mark La Meir, Tristan D. Yan*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Simplified maze procedures involving radiofrequency, cryoenergy and microwave energy sources have been increasingly utilized for surgical treatment of atrial fibrillation as an alternative to the traditional cut-and-sew approach. In the absence of direct comparisons, a Bayesian network meta-analysis is another alternative to assess the relative effect of different treatments, using indirect evidence. A Bayesian meta-analysis of indirect evidence was performed using 16 published randomized trials identified from 6 databases. Rank probability analysis was used to rank each intervention in terms of their probability of having the best outcome. Sinus rhythm prevalence beyond the 12-month follow-up was similar between the cut-and-sew, microwave and radiofrequency approaches, which were all ranked better than cryoablation (respectively, 39, 36, and 25 vs 1%). The cut-and-sew maze was ranked worst in terms of mortality outcomes compared with microwave, radiofrequency and cryoenergy (2 vs 19, 34, and 24%, respectively). The cut-and-sew maze procedure was associated with significantly lower stroke rates compared with microwave ablation [odds ratio
Original languageEnglish
Pages (from-to)201-211
JournalEuropean Journal of Cardio-Thoracic Surgery
Volume48
Issue number2
DOIs
Publication statusPublished - Aug 2015

Keywords

  • Atrial fibrillation
  • Ablation
  • Randomized controlled trial
  • Meta-analysis

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