Role of contact force‐guided radiofrequency catheter ablation for treatment of atrial fibrillation: A systematic review and meta‐analysis

Introduction CF‐sensing catheter emerged as a novel ablation technology and was increasingly used in clinical practice. Nonetheless, available evidence of efficacy and safety comparison between CF‐guided RF catheter ablation and non‐CF‐guided ablation for treatment of AF was still lacking. Methods and results Twenty‐two eligible studies were included after systematic review through the MEDLINE, Google Scholar, the Cochrane Library and PubMed databases. AF/atrial tachycardia‐free survival was markedly improved in CF‐guided catheter ablation compared with non‐CF‐guided ablation at a median 12‐month follow‐up (RR: 1.12, 95% CI: 1.06–1.19, P = 0.000, fixed). Notably, CF‐guided catheter ablation presented a robust survival benefit for treatment of paroxysmal AF (RR: 1.10, 95% CI: 1.03–1.18, P = 0.005, fixed), but not persistent AF (RR: 1.07, 95% CI: 0.89–1.28, P = 0.466, fixed). Moreover, procedure time (WMD: −23.87, 95% CI: −33.83 to −13.91, P = 0.000, random), fluoroscopy time (WMD: −7.78, 95% CI: −13.93 to −1.63, P = 0.013, random) and RF time (WMD: −3.98, 95% CI: −7.78 to −0.17, P = 0.040, random) were significantly reduced in CF‐guided catheter ablation. The incidence of procedure‐related complications did not differ between these two technologies (RR: 0.83, 95% CI: 0.59 to 1.16, P = 0.271, fixed). Conclusion CF‐guided RF catheter ablation was associated with a significant AF/atrial tachycardia‐free survival benefit compared with non‐CF‐guided ablation in patients with paroxysmal AF rather than persistent AF. In addition, CF‐guided ablation strategy also reduced the procedure time, fluoroscopy time, as well as RF time despite no distinct effect on the alleviation of procedure‐related complications.