December 2, 2025Current Medical Research and Opinion2 citationsOpen Access
Comparison of pulse field ablation versus cryoballoon ablation in atrial fibrillation: systematic review and meta-analysis on safety and efficacy
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Key Result
Pulse field ablation and cryoballoon ablation had comparable acute success and 1-year recurrence-free rates, with similar complications except for phrenic nerve palsy occurring exclusively in CBA.
Study Design
Type
Meta-Analysis (n=1,090)
Structured PICO
Does Pulse Field Ablation improve safety and efficacy compared to cryoballoon ablation in patients with atrial fibrillation?
P
Population
1090 patients with atrial fibrillation from 8 studies
I
Intervention
Pulse Field Ablation (PFA)
C
Comparator
Cryoballoon Ablation (CBA)
O
Outcome
Safety and efficacy (acute success, 1-year free recurrence rates, complications)
Pulse field ablation provides comparable efficacy to cryoballoon ablation for atrial fibrillation, with advantages in procedural time, contrast use, and elimination of phrenic nerve palsy risk.
Abstract
BACKGROUND: As the cornerstone of ablation, cryoballoon Ablation (CBA) still has certain limitations, whereas Pulse Field Ablation (PFA) offers a non-thermal and tissue specific alternative. This review aims to compare the safety and efficacy of PFA and CBA. METHODS: A systematic search for eligible studies was conducted in trial registries and databases until August 31, 2024. A total of 1090 patients from eight studies were included. RESULTS: = 75%). Complications were comparable, except for phrenic nerve palsy (PNP) that occurred exclusively in CBA. PFA and CBA are comparable in the terms of acute success and 1-year free recurrence rates. Repeat procedures were more frequent after PFA. However, organized atrial tachycardia (AT) was more commonly observed in the CBA group, while recurrences in both groups were predominantly Atrial Fibrillation (AF). CONCLUSION: PFA offers advantages in procedural time and contrast medium use. Complication rate for PFA and CBA was similar except for PNP which exclusively occurred in CBA.