{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:53:58Z","timestamp":1791219238589,"version":"4.1.0"},"reference-count":62,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"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":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulsed\u2010field ablation (PFA) and high\u2010power short\u2010duration (HPSD) ablation (45\u201390\u2009W) are emerging technologies in atrial fibrillation (AF) treatment, both achieving durable pulmonary vein isolation. We aim to investigate the efficacy and safety of PFA versus HPSD ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We comprehensively searched PubMed, Web of Science (WOS), Scopus, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) through July 2024. Pairwise meta\u2010analysis with reconstructed time\u2010to\u2010event analysis were performed using R version 4.3.1 (PROSPERO ID: CRD42024576031).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven observational studies, including 1904 patients, were included. PFA was significantly associated with lower atrial tachyarrhythmia recurrence compared to HPSD ablation (45\u201390\u2009W) at the longest follow\u2010up (RR: 0.73, 95% CI [0.60, 0.88],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Subgroup analysis revealed a significant reduction in atrial tachyarrhythmia recurrence with PFA versus HPSD ablation (45\u201350\u2009W) (RR: 0.69, 95% CI [0.54, 0.88],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), but not compared to vHPSD ablation (70\u201390\u2009W). Reconnected pulmonary vein rates were significantly lower with PFA compared to HPSD (45\u201350\u2009W) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), while no significant difference was observed compared to vHPSD (70\u201390\u2009W). PFA was significantly associated with reduced procedural duration (MD: \u221233.15 with 95% CI [\u221240.93, \u221225.36],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and left atrial dwell time (MD: \u221232.16 with 95% CI [\u221245.55, \u221218.77],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), although fluoroscopy time increased (MD: 7.48 with 95% CI [4.29, 10.68],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) compared to HPSD ablation (45\u201390\u2009W). Safety profiles were comparable, but pericarditis rates were significantly lower with PFA versus HPSD (45\u201350\u2009W) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and vHPSD (70\u201390\u2009W) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Kaplan\u2013Meier analysis showed a 28% lower risk of atrial tachyarrhythmia recurrence with PFA compared to HPSD ablation (45\u201390\u2009W) (HR: 0.72, 95% CI [0.57, 0.91],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) over an 18\u2010month follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PFA and HPSD ablation (45\u201390\u2009W) are effective and safe for AF ablation. PFA was significantly associated with lower atrial tachyarrhythmia recurrence, shorter procedural duration, reduced left atrial dwell time, increased fluoroscopy time, and comparable safety, with lower rates of pericarditis compared to HPSD ablation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.16728","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T05:44:35Z","timestamp":1748411075000},"page":"1762-1784","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Efficacy and Safety of Pulsed\u2010Field Versus High\u2010Power Short\u2010Duration Ablation for Atrial Fibrillation: A Systematic Review and Meta\u2010Analysis With Reconstructed Time\u2010to\u2010Event Data"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2687-3880","authenticated-orcid":false,"given":"Ahmed Mazen","family":"Amin","sequence":"first","affiliation":[{"name":"Faculty of Medicine Mansoura University Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4261-0638","authenticated-orcid":false,"given":"Mustafa","family":"Turkmani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Michigan State University, Faculty of Medicine East Lansing Michigan USA"},{"name":"Department of Internal Medicine McLaren Health Care Oakland Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saman","family":"Al Barznji","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Michigan State University, Faculty of Medicine East Lansing Michigan USA"},{"name":"Department of Internal Medicine McLaren Health Care Oakland Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanghamitra","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0038-9231","authenticated-orcid":false,"given":"Rachel M.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology Medical University of South Carolina (MUSC) Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Winterfield","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Division of Cardiology Medical University of South Carolina (MUSC) Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhanunjaya","family":"Lakkireddy","sequence":"additional","affiliation":[{"name":"Kansas City Heart Rhythm Institute Overland Park Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0023-9666","authenticated-orcid":false,"given":"Pasquale","family":"Santangeli","sequence":"additional","affiliation":[{"name":"Section of Cardiac Pacing and Electrophysiology Heart and Vascular Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6508-4047","authenticated-orcid":false,"given":"Luigi","family":"Di Biase","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology Albert Einstein College of Medicine at Montefiore Health System New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5487-0728","authenticated-orcid":false,"given":"Andrea","family":"Natale","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin Texas USA"},{"name":"Department of Biomedicine and Prevention, Division of Cardiology University of Tor Vergata Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"37","article-title":"A Roadmap to Improve the Quality of Atrial Fibrillation Management: Proceedings From the Fifth Atrial Fibrillation Network\/European Heart Rhythm Association Consensus Conference","volume":"18","author":"Kirchhof P.","year":"2016","journal-title":"European Pacing, Arrhythmias, and Cardiac 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