单次与双次房间隔穿刺用于心房颤动射频消融：系统评价与荟萃分析。
完整摘要 · 中文译文
背景：单次穿刺技术已成为传统双房间隔穿刺用于心房颤动（AF）射频消融的一种替代方案。本荟萃分析旨在比较这两种方法的疗效与安全性。 方法：我们系统检索了PubMed、Embase和Cochrane Library，截至2026年3月1日。纳入比较AF消融过程中单次与双次房间隔穿刺的前瞻性和回顾性队列研究。主要结局为窦性心律维持。次要结局包括总手术时间、透视时间和围术期并发症。数据采用随机效应模型合并，异质性采用I²统计量评估。 结果：共纳入4项研究，涉及1811例患者。单次穿刺组与双次穿刺组在3个月窦性心律维持方面未观察到显著差异（OR 1.20，95% CI：0.95-1.51，P = 0.13）。透视时间数值相似（MD -0.84，95% CI：-4.80-3.11，P = 0.68），而单次房间隔穿刺的手术时长显著更长（MD 11.65，95% CI：2.62-20.69，P = 0.01）。两种策略的围术期并发症发生率相似（OR 0.81，95% CI：0.47-1.38，P = 0.43）。 结论：单次房间隔穿刺是心房颤动消融中双次穿刺的有效且安全的替代方案，尽管手术时长更长，但其心律结局、透视暴露和并发症发生率相当。 系统评价注册：https://www.crd .york.ac.uk/prospero/view/CRD420261300869，标识符：CRD420261300869。
完整摘要 · 英文原文
BACKGROUND: The single puncture technique has emerged as an alternative to conventional double transseptal puncture for radiofrequency ablation of atrial fibrillation (AF). This meta-analysis aimed to compare the efficacy and safety of these two approaches. METHODS: We systematically searched PubMed, Embase, and the Cochrane Library up to 1st March, 2026. Prospective and retrospective cohort studies comparing single vs. double transseptal puncture during AF ablation were included. The primary outcome was the sinus rhythm maintenance. Secondary outcomes included total procedure time, fluoroscopy time, and periprocedural complications. Data were pooled using a random-effects model, and heterogeneity was assessed with the I² statistic. RESULTS: Four studies involving 1811 patients were included. No significant difference was observed in 3-month sinus rhythm maintenance between the single- and double-puncture groups (OR 1.20, 95% CI: 0.95-1.51, P = 0.13). While fluoroscopy time presented similar values (MD -0.84, 95% CI: -4.80-3.11, P = 0.68), procedure duration was significantly longer with single transseptal puncture (MD 11.65, 95% CI: 2.62-20.69, P = 0.01). The incidence of periprocedural complications was similar between the two strategies (OR 0.81, 95% CI: 0.47-1.38, P = 0.43). CONCLUSIONS: Single transseptal puncture represents an effective and safe alternative to double puncture for atrial fibrillation ablation, with comparable rhythm outcomes, fluoroscopy exposure and complication rates, despite longer procedural duration. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/view/CRD420261300869, Identifier: CRD420261300869.