ReviewJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026
Efficacy, safety, and procedural outcomes of pulsed field ablation for cavotricuspid isthmus-dependent atrial flutter: a systematic review and single-arm meta-analysis.
Review in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCavotricuspid isthmus (CTI) dependent atrial flutter (AFL) is conventionally managed using radiofrequency catheter ablation. Pulsed field ablation (PFA) is an emerging non-thermal ablation technique using electroporation to create lesions across CTI. While it is well established for pulmonary vein isolation in atrial fibrillation, its effectiveness in CTI-dependent atrial flutter remains insufficiently characterized.
methodsThis meta-analysis followed PRISMA guidelines, with a comprehensive search of databases through December 2025. Eligible studies included adult patients undergoing CTI ablation using PFA and reporting CTI-specific outcomes. Pooled event rates and means with 95% confidence intervals (CIs) were estimated using a random-effects model, with heterogeneity evaluated using the I
resultsEighteen studies were included. The pooled rate of acute bidirectional CTI block was 98.1% (95% CI: 96.8-99.5; I
conclusionPFA demonstrates high procedural effectiveness in CTI-dependent atrial flutter, with good short-term durability and low complication rates. Despite predominantly observational data, PFA appears to be a promising approach for CTI ablation. Larger prospective and randomized trials are needed to establish its long-term efficacy and clinical utility.
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