Pulsed field ablation showed lower atrial fibrillation recurrence compared to radiofrequency ablation (RR 0.85, p<0.05) and cryoablation (RR 0.81, p<0.01).
Meta-Analysis (n=7,944)
Does pulsed field ablation improve procedural outcomes and reduce recurrence compared to radiofrequency ablation or cryoablation in patients with atrial fibrillation?
Pulsed field ablation demonstrates lower recurrence rates, shorter procedure times, and a favorable complication profile compared to established thermal ablation techniques for atrial fibrillation.
Effect estimate: RR 0.85
p-value: p=<0.05
BACKGROUND: While radiofrequency ablation (RFA) and cryoablation (CBA) are established treatments for atrial fibrillation (AF), pulsed field ablation (PFA) offers potential benefits. This study compares PFA's procedural outcomes with RFA and CBA. METHODS: A PRISMA-guided systematic review searched PubMed, Cochrane, Embase, and Scopus through September 2024. Studies comparing PFA to RFA or CBA in paroxysmal and persistent AF were included. RESULTS: From 1413 titles, 28 studies (7944 patients, 4-13 months follow-up) met inclusion criteria. PFA showed lower recurrence versus RFA (RR = 0.85, p < 0.05) and CBA (RR = 0.81, p < 0.01). Procedure times were shorter versus RFA (-46.39 min, p < 0.01) and CBA (-9.26 min, p < 0.01). PFA had fewer complications than CBA (RR = 0.45, p < 0.01) and thermal ablation (RR = 0.55, p < 0.01), with similar rates to RFA (RR = 0.81, p = 0.25). Fluoroscopy times were higher. CONCLUSION: Promising results with PFA suggest it as a viable alternative to thermal ablation.
Prajapati et al. (Tue,) conducted a meta-analysis in Atrial Fibrillation (n=7,944). Pulsed field ablation (PFA) vs. Radiofrequency ablation (RFA) and cryoablation (CBA) was evaluated on Recurrence (RR 0.85, p=<0.05). Pulsed field ablation showed lower atrial fibrillation recurrence compared to radiofrequency ablation (RR 0.85, p<0.05) and cryoablation (RR 0.81, p<0.01).