Pulsed field ablation versus cryoballoon ablation in the treatment of atrial fibrillation:a meta-analysis
10.3969/j.issn.1008-794X.2025.04.004
- VernacularTitle:脉冲场消融与冷冻球囊消融治疗心房颤动的Meta分析
- Author:
Baoxing SHAO
1
;
Lianghua CHEN
;
Yan HAO
Author Information
1. 250013 山东济南 山东第一医科大学附属中心医院心内科
- Keywords:
atrial fibrillation;
pulse field ablation;
cryoballoon ablation;
pulmonary vein isolation
- From:
Journal of Interventional Radiology
2025;34(4):362-369
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effectiveness and safety of pulsed field ablation(PFA)and cryoballoon ablation(CBA)in treating atrial fibrillation(AF).Methods A computerized retrieval of academic papers concerning the comparison of the effectiveness and safety between PFA and CBA in treating AF from the databases of PubMed,Web of Science,Cochrane and Embase was conducted.The retrieval time period was from the establishment of the database to May 31,2024.Stata 18.0 software was used to make meta-analysis.Results A total of 12 articles including 3 765 AF patients were included in this analysis.Of the 3 765 AF patients,1 430 received PFA and 2 335 received CBA.In the PFA group,the total operation time(MD=-0.85,95％CI=-1.43 to-0.28,P=0.004),the phrenic nerve injury(OR=0.09,95％CI=0.04-0.24,P＜0.001),and the esophageal injury(OR=0.20,95％CI=0.04-0.90,P=0.036)were statistically significant different from those in the CBA group;while the X-ray fluoroscopy time(MD=0.31,95％CI=-0.02 to 0.63,P=0.066),the recurrence rate of atrial arrhythmia(OR=0.73,95％CI=0.53-1.01,P=0.057),and the incidence of pericardial tamponade(OR=2.37,95％CI=0.97-5.81,P=0.058)were not significantly different from those in the CBA group.Age-subgroup analysis revealed that in patients ≤65 years of age PFA could more remarkably reduce the recurrence rate of atrial arrhythmia than CBA(OR=0.61,95％CI=0.42-0.89,P=0.01),while in patients＞65 years of age the difference in reducing the recurrence rate of atrial arrhythmia between PFA and CBA was not statistically significant(OR=1.04,95％CI=0.69-1.56,P=0.853).Conclusion In treating AF,PFA is superior to CBA in shortening the operation time as well as in reducing the injury of phrenic nerve and esophagus,and there is no significant difference between CBA and PFA in the X-ray fluoroscopy time,the recurrence rate of atrial arrhythmia,and the incidence of cardiac tamponade.
