SynthesisBMC cardiovascular disorders2026
Efficacy and safety of pulsed field ablation versus conventional thermal techniques for patients with atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Clinical Outcomes of Pulsed Field Vs. Thermal Ablation for Paroxysmal Atrial Fibrillation: Systematic Review and Meta-Analysis of Randomized Evidence.Journal of arrhythmia · 2026Article
- Pulsed Field Ablation for Atrial Fibrillation: Mechanism, Clinical Evidence, and Emerging Applications.Cureus · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia and a leading cause of stroke. Pulsed field ablation (PFA) emerges as a novel, non-thermal energy source offering myocardial-selective ablation with a potentially improved safety and efficacy profile.
objectivesTo compare the safety and efficacy of PFA versus RFA/CBA ablation in patients with AF.
methodsMultiple databases were systematically searched from inception to May 2025. Randomized Controlled Trials (RCTs) comparing PFA versus thermal ablation (TA) were analyzed using risk ratio (RR) and mean difference (MD) with 95% Confidence Intervals (CI). Random-effects model was employed to account for heterogeneity, as measured by I2 and quantified using leave-one-out analysis.
resultsWe included 1,294 patients, of whom 653 (50.4%) underwent PFA from four RCTs. Among the included patients, 62.4% have hypertension and a CHA2DS2-VASc mean score of 2.0 ± 1.4. In the pooled analysis, no significant differences were found between PFA group when compared to TA regarding treatment success (RR = 1.11; 95% CI 0.87–1.42; ρ = 0.20), serious adverse events (RR = 1.24; 95% CI 0.38–4.09; ρ = 0.51), recurrent atrial arrhythmias (RR = 0.86; 95% CI 0.54–1.38; ρ = 0.31), and repeat ablation (RR = 0.89; 95% CI 0.18–4.38; ρ = 0.78). However, the procedural time (MD = -38.80 min; 95% CI -75.52–2.08; ρ = 0.04) was significantly reduced in patients who underwent PFA.
conclusionPFA appears comparable to radiofrequency and cryoballoon ablation for atrial fibrillation, with shorter procedure times but similar efficacy and complication rates. Given that most outcomes were graded as low or very low certainty, further large, long-term randomized trials are needed to confirm these findings.
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