Abstract
As a competitive nonthermal energy technique used in atrial fibrillation (AF), the effectiveness and safety of pulsed field ablation (PFA) has remained uncertain. The authors meta-analysis aimed to investigate the effectiveness and safety of PFA in treating AF patients and compare its outcomes with conventional thermal ablation. The PubMed, Embase, and Cochrane Library databases were systematically searched until January 2024 for relevant studies investigating the use of PFA for AF. A fixed-effects model was used for pooled analysis if the I2 value was<50%; otherwise, a random-effects model was applied. A total of 46 studies were included in this analysis. The single-arm meta-analysis of 40 studies showed an acute pulmonary vein isolation (PVI) rate of 99.79% per pulmonary vein (PV) and 99.47% per patient, with atrial arrhythmia recurrence rates of 12.36%, 12.42%, and 23.28% at 3, 6, and 12months, respectively. The safety outcomes incidence was low. In the comparison of 21 studies between PFA and thermal ablation, PFA demonstrated comparable acute PVI rates but a higher first-pass isolation rate. PFA was associated with a lower incidence of atrial arrhythmia recurrence after 3months and phrenic nerve paralysis or injury, but a higher risk of cardiac perforation or tamponade. Procedure time was shorter with PFA. PFA showed noninferiority to thermal ablation in acute PVI and superiority in first-pass isolation, atrial arrhythmia recurrence, phrenic nerve paralysis or injury, and procedure time. However, PFA treatment exhibited a higher risk of cardiac perforation or tamponade.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call