Evidence map›Paper›PMID 38984363›Full record

ReviewHeart rhythm O22024

Pulsed-field ablation versus thermal ablation for atrial fibrillation: A meta-analysis.

Maria Clara Azzi Vaz de Campos, Vitor Ryuiti Yamamoto Moraes, Rafael Ferreira Daher, José Pedro Cassemiro Micheleto, Luiza Azzi Vaz de Campos, Guilherme Fleury Alves Barros, Heitor Martins de Oliveira, Lorrany Pereira Barros, Antonio da Silva Menezes

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Heart rhythm O2, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Pulsed field ablation and the risk of hemolysis-driven acute kidney injury: a systematic review and meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Pooled it
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  8. Article
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  10. Pulsed-field ablation versus cryoballoon ablation in patients with atrial fibrillation: A systematic review, meta-analysis and meta-regression.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Review
  11. Ablation with the circular pulsed field ablation catheter: Tips & techniques for using the PulseSelect catheter.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Review
  12. Article
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  17. Pulsed-field ablation versus thermal ablation in the management of atrial fibrillation: A narrative review.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Maria Clara Azzi Vaz de CamposInternal Medicine, Medical Sciences and Life School, Pontifical Catholic University of Goiás, Goiânia, Goiás, Brazil.
Vitor Ryuiti Yamamoto MoraesClinical Medicine Department, Medical School, Evangelical University of Goiás, Anápolis, Goiás, Brazil.
Rafael Ferreira DaherInternal Medicine, Medical Sciences and Life School, Pontifical Catholic University of Goiás, Goiânia, Goiás, Brazil.
José Pedro Cassemiro MicheletoClinical Medicine Department, Medicine Faculty, Federal University of Alagoas, Maceió, Alagoas, Brazil.
Luiza Azzi Vaz de CamposInternal Medicine, Medical Sciences and Life School, Pontifical Catholic University of Goiás, Goiânia, Goiás, Brazil.
Guilherme Fleury Alves BarrosInternal Medicine Department, Medical Faculty, Federal University of Goiás, Goiânia, Goiás, Brazil.
Heitor Martins de OliveiraInternal Medicine, Medical Sciences and Life School, Pontifical Catholic University of Goiás, Goiânia, Goiás, Brazil.
Lorrany Pereira BarrosInternal Medicine, Medical Sciences and Life School, Pontifical Catholic University of Goiás, Goiânia, Goiás, Brazil.
Antonio da Silva MenezesInternal Medicine, Medical Sciences and Life School, Pontifical Catholic University of Goiás, Goiânia, Goiás, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Pulsed-field ablation (PFA) is an alternative to thermal ablation (TA) in patients with atrial fibrillation (AF) receiving catheter-based therapy for pulmonary vein isolation (PVI). However, its efficacy and safety have yet to be fully elucidated. Objective: The purpose of this study was to compare the acute and long-term efficacies and safety of PFA and TA. Methods: We performed a systematic review and meta-analysis of randomized and nonrandomized controlled trials comparing PFA and TA in patients with AF undergoing their first PVI ablation. The TA group was divided into cryoballoon (CB) and radiofrequency subgroups. AF patients were divided into paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (PersAF) subgroups for further analysis. Results: Eighteen studies involving 4998 patients (35.2% PFA) were included. Overall, PFA was associated with a shorter procedure time (mean difference [MD] -21.68; 95% confidence interval [CI] -32.81 to -10.54) but longer fluoroscopy time (MD 4.53; 95% CI 2.18-6.88) than TA. Regarding safety, lower (peri-)esophageal injury rates (odds ratio [OR] 0.17; 95% CI 0.06-0.46) and higher tamponade rates (OR 2.98; 95% CI 1.27-7.00) were observed after PFA. In efficacy assessment, PFA was associated with a better first-pass isolation rate (OR 6.82; 95% CI 1.37-34.01) and a lower treatment failure rate (OR 0.83; 95% CI 0.70-0.98). Subgroup analysis showed no differences in PersAF and PAF. CB was related to higher (peri)esophageal injury, and lower PVI acute success and procedural time. Conclusion: Compared to TA, PFA showed better results with regard to acute and long-term efficacy but significant differences in safety, with lower (peri)esophageal injury rates but higher tamponade rates in procedural data.

Indexed as

Cryoballoon ablationParoxysmal atrial fibrillationPersistent atrial fibrillationPulmonary vein isolationPulsed-field ablationRadiofrequency ablationThermal ablation

Identifiers

PMID38984363
PMCPMC11228281

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.