Arrhythmias & electrophysiology
Incidence of silent cerebral events detected by MRI in patients with atrial fibrillation undergoing pulsed field ablation vs thermal ablation: A systematic review and network meta-analysis
Authors' conclusion
Our findings indicate that a substantial proportion of patients experience SCEs after catheter ablation for AF, with an overall incidence of approximately 19.1% occurring within 1 week (mostly within 72 hours) after ablation. No significant differences were observed in SCE incidence between pulsed field ablation and thermal ablation or between the Farawave catheter and most thermal catheters.
Study context
- Population
- Patients with atrial fibrillation (AF) undergoing catheter ablation
- Participants
- 10,456 patients86 trials
- Comparison
- SCE incidence across energy sources and catheter types
- Outcome
- Pooled SCE incidence
- Follow-up
- Within 1 week (mostly within 72 hours) after ablation
Pooled result
As reported in the abstract
Pooled SCE incidence
19.1%
Further pooled results
| Outcome | Values | Relative risk (95% CrI) | |
|---|---|---|---|
| SCE incidence by catheter typeFarawave cathetervs HD Mesh Ablator | HD Mesh Ablator 15.1% · PVAC catheter 36.2% · Farawave catheter 18.5% | 0.15 (0.03–0.89) | |
| 0.050.21520Relative risk (log scale) |
| Outcome | Values |
|---|---|
| SCE incidence by energy source | Pulsed field ablation 14.4% · Radiofrequency ablation 17.7% · Cryoballoon ablation 20.8% · Laser ablation 32.7% |
SCE incidence by energy source
- No significant differences between pulsed field ablation and thermal ablation in SCE incidence
SCE incidence by catheter type
- Farawave showed no significant differences compared with most thermal catheters
Original publication
Incidence of silent cerebral events detected by MRI in patients with atrial fibrillation undergoing pulsed field ablation vs thermal ablation: A systematic review and network meta-analysis. Heart Rhythm. Published 11 April 2025. doi:10.
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