What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Atrial Fibrillation (n=6961). Intervention: Pulsed Field Ablation (PFA) vs. Radiofrequency Ablation (RFA) and Cryoballoon Ablation (CBA). Primary outcome: AF recurrence.

March 23, 2026Open Access

A Network Meta-Analysis of Comparative Effectiveness and Safety of Pulsed Field, Radiofrequency, and Cryoballoon Ablation for Atrial Fibrillation

Key Result

Pulsed field ablation showed lower AF recurrence and shorter procedure times vs cryoballoon ablation (MD -14.25 min), but longer fluoroscopy times vs RFA (MD +6.8 min) and CBA (MD +3.9 min).

Key Points

This research aims to evaluate and compare the effectiveness and safety of pulsed field, radiofrequency, and cryoballoon ablation for atrial fibrillation.
Conducted a network meta-analysis of data from 6,961 patients
Compared outcomes across pulsed field ablation, radiofrequency ablation, and cryoballoon ablation
Measured recurrence rates and fluoroscopy times
Pulsed field ablation showed lower recurrence of atrial fibrillation compared to both radiofrequency and cryoballoon ablation
Fluoroscopy times were longer for pulsed field ablation when compared to radiofrequency and cryoballoon ablation
Pulsed field ablation demonstrated favorable efficacy with shorter procedure times and similar safety profiles

Study Design

Type

Meta-Analysis (n=6,961)

Structured PICO

Does Pulsed Field Ablation reduce atrial arrhythmia recurrence and periprocedural complications compared to Radiofrequency and Cryoballoon Ablation in adult patients with atrial fibrillation?

Population

6,961 adult patients diagnosed with atrial fibrillation (AF) undergoing catheter ablation, pooled from 34 studies (RCTs and observational studies).

Intervention

Pulsed Field Ablation (PFA)

Comparator

Radiofrequency Ablation (RFA) and Cryoballoon Ablation (CBA)

Outcome

Atrial arrhythmia recurrence and periprocedural complicationscomposite

Pulsed field ablation demonstrates superior efficacy in preventing atrial arrhythmia recurrence and shorter procedure times compared to thermal ablation modalities, with comparable overall periprocedural safety.

Abstract

Tweet: In our network meta-analysis of 6,961 patients, #PFA showed superior outcomes vs #RadiofrequencyAblation and #CryoballoonAblation with lower AF recurrence, shorter J o u r n a l P r e -p r o o f and CBA (MD -14.25 min), but longer fluoroscopy times versus RFA (MD +6.8 min) and CBA (MD +3.9 min). ConclusionsPFA demonstrates favorable efficacy and shorter procedure times with similar overall safety.

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Cite This Study

Yadav et al. (Sun,) conducted a meta-analysis in Atrial Fibrillation (n=6,961). Pulsed Field Ablation (PFA) vs. Radiofrequency Ablation (RFA) and Cryoballoon Ablation (CBA) was evaluated on AF recurrence. Pulsed field ablation showed lower AF recurrence and shorter procedure times vs cryoballoon ablation (MD -14.25 min), but longer fluoroscopy times vs RFA (MD +6.8 min) and CBA (MD +3.9 min).

synapsesocial.com/papers/69c0e007fddb9876e79c16bf https://doi.org/https://doi.org/10.1016/j.hroo.2026.03.015