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Updated: May 1, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Evaluating Pulsed Field Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis of Procedural
Poojan Prajapati1, Hema S Vemulapalli1, Juan F Rodriguez-Riascos1
1Department of Cardiovascular Diseases, Mayo Clinic, Phoenix, Arizona, USA.
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.
