Arrhythmias & electrophysiologyMeta-analysis
Pulsed field ablation vs. thermal ablation for pulmonary vein isolation: a network meta-analysis of randomized controlled trials
- Systematic review and network meta-analysis of randomised controlled trials
Authors' conclusion
The present data indicate that, in patients undergoing a first transcatheter AF ablation, PFA may be associated with favourable efficacy and procedural efficiency compared with traditional thermal technologies, while showing a broadly comparable safety profile.
Study context
- Population
- Patients undergoing first-attempt pulmonary vein isolation for atrial fibrillation (AF)
- Participants
- 4,162 patients · 18 studies
- Comparison
- Pulsed field ablation (PFA) vs thermal ablation
- Outcome
- Recurrence of any sustained atrial tachyarrhythmia (ATA)
- Follow-up
- 12-month follow-up
Pooled result
As reported in the abstract
Each group vs PFARelative risk (95% CI)
RFA
1.48(1.10–2.00)
CBA
1.43(1.07–1.92)
LBA
1.29(0.84–1.98)
Further pooled results
Procedural and fluoroscopy time
- PFA exhibited the lowest procedural time among transcatheter energy sources (ES)
- RFA displayed a significantly lower fluoroscopy time
Atrial tachyarrhythmia (ATA) recurrence, paroxysmal AF only and contemporary technologies (subgroups)
- Consistent findings
Safety
Major periprocedural complications
- No significant differences
Original publication
Pulsed field ablation vs. thermal ablation for pulmonary vein isolation: a network meta-analysis of randomized controlled trials. Europace. Published 11 May 2026. doi:10.1093/europace/euag112
Summarised from the published abstract; every number is checked against it