Abstract 17069: Efficacy and Safety of Pulsed Field Ablation For Atrial Fibrillation: A Systematic Review and Meta-Analysis

Abstract

Introduction: Pulsed-field ablation (PFA) is a novel ablation modality to treat atrial fibrillation (AF) with high tissue selectivity and thereby potentially lesser complications compared to thermal ablation. Hypothesis: We aimed to analyze the efficacy and safety of PFA in the treatment of AF. Methods: A systematic search of Embase, Medline, Scopus, and Web of Science was conducted from inception till May 2023 to identify all the studies that included patients undergoing pulsed field ablation for the treatment of AF. We pooled outcomes using a random-effects model. All analyses was performed using the OpenMetaAnalyst software. Results: A total of 24 studies including 2,256 patients met our inclusion criteria. Acute isolation of all pulmonary veins was achieved in 99.7% of all patients (95% confidence interval (CI): 99.4%-99.9%; I 2 : 0%). The average total procedure time was 81 (95% CI: 69-93; I 2 : 99%) minutes, and the average fluoroscopy time was 14 (95% CI: 12-16; I 2 : 98%) minutes. The overall complication rate was 2.9% (95% CI: 1.4%-4.0%; I 2 : 71%). At a mean follow-up of 6.6 months, the overall rate of arrhythmia recurrence after the blanking period of 90 days was 17% (95% CI: 11%-24%; I 2 : 94%). Conclusion: PFA has a high procedural success with low complication and recurrence rates. Further randomized controlled trials are needed to compare its long-term efficacy and safety against conventional ablation techniques.