Efficacy and safety of pulsed field ablation compared to cryoballoon ablation in the treatment of atrial fibrillation: a meta-analysis Article Swipe
Isabel Rudolph
,
G Mastella
,
Isabell Bernlochner
,
Alexander Steger
,
Gesa von Olshausen
,
Franziska Hahn
,
Reza Wakili
,
Karl‐Ludwig Laugwitz
,
Eimo Martens
,
Manuel Rattka
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/ehjopen/oeae044
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/ehjopen/oeae044
Aims Pulmonary vein isolation (PVI) represents the gold standard in the treatment of atrial fibrillation (AF) and the use of single-shot techniques, such as cryoballoon ablation (CBA) and pulsed field ablation (PFA) using a pentaspline catheter, has gained prominence. Recent studies hypothesize that PFA might be superior to CBA, although procedural efficacy and safety data are inconsistent. A meta-analysis was conducted to compare both energy sources for the treatment of AF. Methods and results A structured systematic database search and meta-analysis were performed on studies investigating outcomes, periprocedural complications, and/or procedural parameters of AF patients treated by either CBA or PFA. Eleven studies reporting data from 3805 patients were included. Pulmonary vein isolation by PFA was associated with a significantly lower recurrence of atrial fibrillation/atrial tachycardia [odds ratio (OR) = 0.73, 95% confidence interval (CI) = 0.54–0.98, I2 = 20%] and fewer periprocedural complications (OR = 0.62, 95% CI = 0.40–0.96, I2 = 6%) compared to CBA. The lower complication rate following PFA was mainly driven by fewer phrenic nerve injuries (OR = 0.19, 95% CI = 0.08–0.43, I2 = 0%). However, there were more cases of cardiac tamponades after PFA (OR = 2.56, 95% CI = 1.01–6.49, I2 = 0%). Additionally, using PFA for PVI was associated with shorter total procedure times [mean difference (MD) = −9.68, 95% CI = −14.92 to −4.43 min, I2 = 92%] and lower radiation exposure (MD = −148.07, 95% CI = −276.50 to −19.64 µGy·mI2 = 7%). Conclusion Our results suggest that PFA for PVI, compared to CBA, enables shorter procedure times with lower arrhythmia recurrence and a reduced risk of periprocedural complications. Randomized controlled trials need to confirm our findings.
Related Topics
Concepts
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ehjopen/oeae044
- https://academic.oup.com/ehjopen/advance-article-pdf/doi/10.1093/ehjopen/oeae044/57986236/oeae044.pdf
- OA Status
- gold
- Cited By
- 13
- References
- 22
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4399140858
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4399140858Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/ehjopen/oeae044Digital Object Identifier
- Title
-
Efficacy and safety of pulsed field ablation compared to cryoballoon ablation in the treatment of atrial fibrillation: a meta-analysisWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-05-01Full publication date if available
- Authors
-
Isabel Rudolph, G Mastella, Isabell Bernlochner, Alexander Steger, Gesa von Olshausen, Franziska Hahn, Reza Wakili, Karl‐Ludwig Laugwitz, Eimo Martens, Manuel RattkaList of authors in order
- Landing page
-
https://doi.org/10.1093/ehjopen/oeae044Publisher landing page
- PDF URL
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https://academic.oup.com/ehjopen/advance-article-pdf/doi/10.1093/ehjopen/oeae044/57986236/oeae044.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/ehjopen/advance-article-pdf/doi/10.1093/ehjopen/oeae044/57986236/oeae044.pdfDirect OA link when available
- Concepts
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Medicine, Pulmonary vein, Atrial fibrillation, Ablation, Confidence interval, Catheter ablation, Atrial tachycardia, Odds ratio, Meta-analysis, Internal medicine, Cardiology, Cryoablation, SurgeryTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
13Total citation count in OpenAlex
- Citations by year (recent)
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2025: 11, 2024: 2Per-year citation counts (last 5 years)
- References (count)
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22Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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