Pulsed-field ablation versus thermal ablation for persistent atrial fibrillation: a systematic review and meta-analysis | Sciact - Система учета научной деятельности ИМ СО РАН

Pulsed-field ablation versus thermal ablation for persistent atrial fibrillation: a systematic review and meta-analysis Научная публикация

Журнал

Патология кровообращения и кардиохирургия
ISSN: 1681-3472 , E-ISSN: 2500-3119

Вых. Данные

Год: 2025, Том: 29, Номер: 4, Страницы: 54-66 Страниц : 13 DOI: 10.21688/1681-3472-2025-4-54-66

Ключевые слова

atrial fibrillation; catheter ablation; electroporation; persistent atrial fibrillation; pulsed field ablation; thermal ablation

Авторы

Kashapov Robert I.Kashapov ¹ , Guseva Anastasia V.Guseva ² , Khrushchev Sergey E.Khrushchev ³ , Ruzankin Pavel S.Ruzankin ³ , Romanov Alexander B.Romanov ²

Организации

1	E. Meshalkin National Medical Research Center, Novosibirsk
2	E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, Novosibirsk, Russian Federation
3	Sobolev Institute of Mathematics, Novosibirsk, Russian Federation

Информация о финансировании (1)

Министерство здравоохранения РФ

124022000090-0

Background: Pulsed field ablation (PFA) is a widespread safe and effective approach to treat paroxysmal atrial fibrillation (AF). However, data regarding its use in persistent AF are limited, especially in comparison with thermal energy sources. Objective: The study aimed to assess the efficacy and safety of PFA for persistent AF treatment in comparison with radiofrequency (RFA) and cryoballoon ablations (CBA). The primary concern was to evaluate 1 year freedom from any atrial arrhythmias (AA) recurrence, including AF, atrial flutter or atrial tachycardia lasting 30 seconds or longer after the blanking period. Methods: We performed an extensive search using MEDLINE, EMBASE, and PubMed databases for studies providing outcome data on PFA in patient with persistent AF. Additionally, several studies on RFA and CBA involvement for persistent AF treatment were selected for comparative analysis. Results: Freedom from AA at 1 year after PFA, RFA and CBA was 68.95% [95 % CI 62.72%, 74.57%], 61.72% [95 % CI 51.74%, 70.79%], 68.23% [95 % CI 63.76%, 72.39%] respectively, with no significant differences between types of energy used. No significant differences were revealed in periprocedural and postprocedural complications between compared ablation types, as well. Conclusion: In patients with persistent AF, PFA required a shorter total procedural time than RFA but a longer one than CBA. Fluoroscopy time for PFA was significantly shorter than for thermal energy sources. No significant differences were found in safety or freedom from atrial arrhythmias at the 1-year follow-up between the compared ablation methods. Large randomized multicenter trials are needed to further assess the benefits of PFA compared to thermal energy sources in persistent AF treatment.

Kashapov R.I.K. , Guseva A.V.G. , Khrushchev S.E.K. , Ruzankin P.S.R. , Romanov A.B.R.
Pulsed-field ablation versus thermal ablation for persistent atrial fibrillation: a systematic review and meta-analysis
Патология кровообращения и кардиохирургия. 2025. Т.29. №4. С.54-66. DOI: 10.21688/1681-3472-2025-4-54-66 OpenAlex

Поступила в редакцию:	14 нояб. 2025 г.
Принята к публикации:	1 дек. 2025 г.
Опубликована online:	21 янв. 2026 г.

OpenAlex:

W7125371792

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