{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:03:18Z","timestamp":1791295398267,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With over 60 million cases worldwide, atrial fibrillation (AF) is one of the most common cardiac arrhythmias in adults. Pulsed\u2010field ablation (PFA) has emerged as a significant alternative to thermal ablation for pulmonary vein isolation (PVI). This systematic review and meta\u2010analysis investigated the efficacy and safety of PFA versus thermal ablation in patients undergoing first\u2010time PVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library from inception to 2025. Hazard ratios (HRs) with 95% confidence intervals (CIs) were derived from reconstructed Kaplan\u2013Meier survival curves to compare atrial tachyarrhythmia recurrence between PFA and thermal ablation. Random\u2010effects models were used to compare AF recurrence, durable PVI, redo procedures, phrenic nerve palsy (PNP), and other safety outcomes between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 27 studies comprising 8546 patients were included. Kaplan\u2013Meier reconstruction from ten studies demonstrated higher 12\u2010month arrhythmia\u2010free survival with PFA compared with thermal ablation (78.4% [95% CI, 76.1\u201380.8] vs. 73.4% [95% CI, 71.5\u201375.4]). Thermal ablation was associated with a significantly higher risk of atrial tachyarrhythmia recurrence (HR 1.28, 95% CI 1.10\u20131.48;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Subgroup analyses demonstrated that PFA significantly reduced the recurrence risk in patients with paroxysmal AF (HR 1.63, 95% CI 1.31\u20132.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas no significant difference was observed in those with persistent AF (HR 1.13, 95% CI 0.92\u20131.41;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.25).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PFA was associated with lower rates of atrial tachyarrhythmia and AF recurrence rates than thermal ablation in patients undergoing first\u2010time PVI; however, these findings should be interpreted cautiously, given the predominance of observational studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70438","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T05:58:17Z","timestamp":1786082297000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulsed Field Ablation Versus Thermal Ablation for First\u2010Time Pulmonary Vein Isolation in Atrial Fibrillation: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9214-8891","authenticated-orcid":false,"given":"Yousef Radwan","family":"Alnomani","sequence":"first","affiliation":[{"name":"Faculty of Medicine Benha University  Benha Egypt"},{"name":"Medical Research Group of Egypt (MRGE)  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7922-6436","authenticated-orcid":false,"given":"Abdelaziz A.","family":"Awad","sequence":"additional","affiliation":[{"name":"Medical 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Samy","family":"El\u2010Sayed","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE)  Cairo Egypt"},{"name":"Faculty of Medicine Zagazig University  Zagazig Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menna","family":"Marwan","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE)  Cairo Egypt"},{"name":"Faculty of Medicine Port Said University  Port Said Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa Radwan","family":"Mady","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE)  Cairo Egypt"},{"name":"Faculty of Pharmacy Menoufia University  Shebin El\u2010Kom Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Ali","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Al\u2010Azhar University  Damietta 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