{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:53:07Z","timestamp":1792029187650,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary vein isolation is a standard therapy for paroxysmal atrial fibrillation (AF). Pulsed field ablation (PFA) has emerged as a novel approach aiming to improve efficacy and safety over conventional thermal ablation (CTA) (radiofrequency and cryoballoon). This meta\u2010analysis evaluated outcomes of PFA versus thermal ablation in paroxysmal AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic databases were searched through May 2025 for randomized controlled trials (RCTs) and observational studies that compared the efficacy and safety of PFA versus CTA. The primary outcome was AF recurrence. Summary estimates were conducted using random effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of six studies, involving 1928 patients, were included. The incidence of AF recurrence was significantly lower among patients treated with PFA (risk ratio [RR] 0.67; 95% confidence interval [CI] 0.53\u20130.85). PFA was associated with a lower incidence of any atrial arrhythmia recurrence (RR 0.78, 95% CI: 0.61\u20130.99). The total procedure duration was significantly shorter with PFA (mean difference \u221221.46\u2009min (95% CI: \u221226.04 to \u221216.88)), but there was no difference in fluoroscopy time. The rates of esophageal injury and phrenic nerve palsy were lower with PFA. However, the data were limited for these two outcomes, and a meta\u2010analysis was not conducted for them. There was no difference between the two groups in the incidence of stroke or pericardial tamponade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients with paroxysmal AF undergoing catheter ablation, PFA is associated with favorable outcomes, including lower recurrence and shorter procedure time compared to conventional ablation modalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70207","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:15:44Z","timestamp":1761128144000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Outcomes With Pulsed Field Ablation Versus Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation: A Meta\u2010Analysis"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1186-2595","authenticated-orcid":false,"given":"Ahmed Elmorsy","family":"Mohamed","sequence":"first","affiliation":[{"name":"NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Farid","family":"Gadelmawla","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Menoufia University  Menoufia Egypt"},{"name":"Medical Research Group of Egypt Negida Academy  Arlington Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyad","family":"Kholeif","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Baptist Hospitals of Southeast Texas  Beaumont Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elnady","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Kafrelsheikh University  Kafr El\u2010Sheikh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Diaa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Azhar University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Rashwan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine NYC Health and Hospitals\/Lincoln  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5122-8200","authenticated-orcid":false,"given":"Ameer","family":"Awashra","sequence":"additional","affiliation":[{"name":"Department of Medicine An Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Elalfy","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imad","family":"Tahhan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Wellington Regional Medical Center  Wellington Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohab","family":"Elnashar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranem","family":"Afify","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tanta University  Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Mohyeldin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Menoufia University  Menoufia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haytham A. M.","family":"Dwaik","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Jordan  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanwoo","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islam Y.","family":"Elgendy","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Gill Heart and Vascular Institute, University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.02.025"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.064"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.2029"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.772582"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.04.090"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-96655-3"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.15420\/aer.2022.45"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000810"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00399-021-00833-9"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307291"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2502280"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae016"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab090"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab155"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-023-01651-4"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12020719"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2024.04.012"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.13118"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-023-01660-3"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.109.871665"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.70011"},{"issue":"10","key":"e_1_2_11_26_1","first-page":"2232","article-title":"Pulsed Field Ablation of Atrial Fibrillation: A Novel Technology for Safer and Faster Ablation","volume":"12","author":"Carta\u2010Bergaz A.","year":"2024","journal-title":"Biomedicine"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-024-01835-6"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.19102\/icrm.2020.110901"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.008337"},{"issue":"6","key":"e_1_2_11_30_1","first-page":"831","article-title":"Collateral Damage From Catheter Ablation of Atrial Fibrillation: Lessons Learnt in the Past Decade","volume":"5","author":"Wongcharoen W.","year":"2013","journal-title":"Journal of Atrial Fibrillation"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.959186"},{"key":"e_1_2_11_32_1","unstructured":"Biosense Webster Inc \u201cA Study for Treatment of Paroxysmal Atrial Fibrillation (PAF) by Pulsed Field Ablation (PFA) System With Irreversible Electroporation (inspIRE). ClinicalTrials.gov Identifier NCT04524364 \u201d (2025)."},{"key":"e_1_2_11_33_1","unstructured":"Abbott Medical Devices \u201cA Study of the TactiFlex SE Catheter and Volt PFA Generator in Subjects With PAF: (FlexPulse IDE). ClinicalTrials.gov Identifier NCT06676072 \u201d (2025)."},{"key":"e_1_2_11_34_1","unstructured":"CardioFocus \u201cPulmonary Vein Isolation with the Single Shot Endoscopic Ultra\u2010Compliant PFA Balloon for the Treatment of AF (VISION AF). 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