TABLE 1.
Characteristics of studies included in the meta‐analysis
| Study | Design | Origin | Total patients (SS/NSS), n | Follow‐up duration, months | Inclusion criteria | AAD allowed after blanking period a | AA detection | SS used | NSS used |
|---|---|---|---|---|---|---|---|---|---|
| Deyell, 2020 | RC |
Multicentric Canada |
(52, 33) 85 | 12 | PVI alone (no adjunctive linear or complex fractionated electrogram ablation) | No | 24 h Holter monitoring q3 months | Agilis™ NxT small or medium curve sheaths b | 8.5 French SL0 or SL1 sheaths c |
| Errahmouni, 2015 | PC |
Single center Monaco |
(45, 37) 82 | >9 | Consecutive patients who underwent AF ablation using MN coupled with the NSS group were prospectively included | Yes | 24 h Holter monitoring q3 months for the first year, the q6 months afterward | Robotic deflectable sheath | Fast‐Cath SL1 c |
| Guo, 2021 | RC |
Single center China |
(53, 67) 120 | 6 |
Paroxysmal AF First‐time ablation |
No | (ECG) or 24‐h Holter monitoring | Vizigo sheath d | Swartz sheath e |
| Luo, 2022 | Case–control |
Single center China |
(55, 55) 110 | 1 day | AF refractory to at least one antiarrhythmic | NR | NR | MobiCath f | Fast‐Cath SR0 e |
| Masuda, 2016 | PC |
Single center Japan |
(57, 33) 90 | 12 | Patients who underwent an initial ablation for AF | No | 24 h Holter monitoring q3 months | Agilis™ NxT sheaths b | Swartz sheath e |
| Matsuo, 2011 | RCT |
Single center Japan |
(40, 40) 80 | 12 | Persistent AF | Yes |
(ECG) or 24‐h Holter monitoring q3 months Event recorder (available for 5 days) if symptomatic without AA documentation |
Agilis™ NxT sheaths b | 8 French SL0 sheaths c |
| Piorkowski, 2008 | Case–control | Switzerland | (83, 83) 166 | 6 | Cases where matched with previously identified controls who treated with nonsteerable sheaths | Yes |
7‐day Holter ECG at 3 and 6 months |
Agilis™ NxT sheaths b | Mullins g |
| Piorkowski, 2011 | RCT |
2 centers Germany |
(63, 60) 123 | 6 |
(1) Paroxysmal or persistent symptomatic AF (documented on ECG) (2) Refractory to at least 1 AAD (3) LA diameter <60 mm |
Yes | 7‐day Holter ECG at 3 and 6 months | Agilis™ NxT sheaths b | SL0 sheaths c |
| Rajappan, 2009 | RCT |
Single center United Kingdom |
(27) 54 | 6 |
(1) Paroxysmal or persistent symptomatic AF (documented on ECG) (2) Refractory to at least 1 AAD (3) First time ablation |
No | 7‐day Holter monitor | Agilis™ NxT sheaths b | Mullins g |
| Ullah, 2015 | RC |
Single center United Kingdom |
(41, 19) 60 | 12 | Persistent AF, First time ablation | No | NR | Agilis™ NxT sheaths b or Artisan Extend Control Catheter h | Mullins g |
Abbreviations: AA, atrial arrhythmia; AAD, antiarrhythmic drug; AF, atrial fibrillation; LA, left atrium; MN, remote magnetic navigation; NR, not reported; NSS, nonsteerable sheath; PC, prospective cohort; PVI, pulmonary vein isolation; RC, retrospective cohort; RCT, randomized controlled trial; SS, steerable sheath.
Unless AA recurrence observed.
Abbott Medical.
Abbott Medical, St. Paul, MN, USA.
Biosense Webster Inc., Irvine, CA, USA.
St. Jude Inc., St. Paul, MN, USA.
Biosense Webster Inc.
Cook Inc., Bloomington, IN, USA.
Hansen Medical Inc.