Pulsed field ablation vs. medical therapy for atrial fibrillation: a propensity score–matched comparison with the JoFib registry

Introduction Pulsed field ablation (PFA) is a novel, non-thermal method for the treatment of atrial fibrillation (AF). We conducted this study, as part of one of the earliest reports originating from the MENA region, to compare the efficacy of PFA vs. medical therapy alone for the treatment of AF. Methods A retrospective cohort study was conducted in which 62 patients who underwent PFA ablation for AF were compared with a cohort of 62 propensity score–matched patients sourced from the JoFib Registry. Rates of readmission in both arms due to AF recurrence or heart failure exacerbation driven by rapid ventricular response to AF within the period of 1 and 6 months were considered the primary study endpoints. Data were cleaned and analyzed using R 4.5.3. Results Both cohorts were well matched in terms of age, gender, diabetes mellitus, hypertension, heart failure, left atrial diameter, CHA 2 DS 2 -VASc score, ejection fraction, and prior use of antiarrhythmic drugs. Compared with medical therapy, PFA showed significantly lower readmission rates at 1 and 6 months (3.2% and 4.8% vs. 12.9% and 17.7%; p < 0.05). A Kaplan–Meier analysis showed significantly higher freedom from readmission rates in the PFA cohort compared with the JoFib cohort (92% vs. 69%; log-rank p = 0.002). Conclusions This early report from the MENA region aligns with the global consensus supporting PFA as a treatment for AF and lays the foundation for future larger studies to investigate PFA in this specific population.