Impact of image integration on catheter ablation for atrial fibrillation using three-dimensional electroanatomic mapping: a meta-analysis

Pacing Clin Electrophysiol. 2012 Oct;35(10):1242-7. doi: 10.1111/j.1540-8159.2012.03492.x. Epub 2012 Aug 20.


Background: Studies comparing the procedural and clinical outcomes of catheter ablation for atrial fibrillation (AF) guided by CartoMerge and that by Carto have achieved mixed results (Carto, Biosense Webster, Diamond Bar, CA, USA). We collected these studies and conducted a meta-analysis to determine whether CartoMerge results in better procedural and clinical outcomes.

Methods and results: Three randomized controlled trials and two controlled observational studies were collected for analysis. The clinical and procedural outcomes of interest were AF recurrence after catheter ablation, major complications, procedure durations, and fluoroscopy time. Meta-analysis was performed using RevMan 5.0.18 software (The Cochrane Collaboration, Copenhagen, Denmark) and pooled estimates of effect were reported as risk ratios with 95% confidence intervals (CI). The overall results of this meta-analysis indicate that catheter ablation for AF guided by CartoMerge is insignificantly associated with a decreased risk of recurrences (RR = 0.76; 95% CI: 0.55-1.04; P = 0.09) and major complications (RR = 0.73; 95% CI: 0.37-1.45; P = 0.37) compared with that by Carto.

Conclusion: The image integration using CartoMerge guiding catheter ablation for AF does not improve the main clinical outcomes significantly compared with that by Carto in centers with experienced operators.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Atrial Fibrillation / surgery*
  • Catheter Ablation / methods*
  • Electrophysiologic Techniques, Cardiac / methods*
  • Fluoroscopy / methods
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Imaging, Three-Dimensional / methods*
  • Operative Time
  • Postoperative Complications / epidemiology
  • Randomized Controlled Trials as Topic
  • Recurrence
  • Surgery, Computer-Assisted / methods
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome