{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:23:25Z","timestamp":1790735005406,"version":"4.1.0"},"reference-count":0,"publisher":"Global Cardiology Science and Practice","issue":"3","license":[{"start":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T00:00:00Z","timestamp":1751155200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["gcsp"],"abstract":"<jats:p>\n\n\nBackground: Phrenic nerve injury (PNI) and esophageal injury are serious complications associated with atrial fibrillation (AF) ablation procedures. Pulsed field ablation (PFA), a non- thermal modality, has emerged as a promising alternative to conventional thermal ablation techniques, such as radiofrequency ablation (RFA) and cryoballoon ablation (CBA).\nObjective: To evaluate and compare the incidence of PNI and esophageal injury following PFA, RFA, and CBA in patients undergoing AF ablation.\nMethods: A systematic search of The Cochrane Library, MEDLINE, and EMBASE databases was conducted for studies published between 2014 and 2024. Cohort and case-control studies comparing PFA with RFA and\/or CBA in relation to PNI and esophageal injury were included. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model.\nResults: Eleven studies involving 4,603 patients were included in the analysis. The incidence of PNI was 0.23% with PFA, 0.63% with RFA, and 2.68% with CBA, respectively. A meta-analysis of five studies comparing PFA and CBA showed a significantly lower risk of PNI with PFA (RR 0.13, 95% CI 0.04\u20130.35; p &lt; 0.0001). No esophageal injury was reported in the PFA group, compared to 2.79% in the RFA group and 1.45% in the CBA group. Pooled analysis demonstrated that PFA significantly reduced the risk of esophageal injury compared to RFA (RR 0.06, 95% CI 0.01\u20130.29; p = 0.0005) and CBA (RR 0.07, 95% CI 0.01\u20130.39; p = 0.002).\n\n\n\n\n\n\nConclusion: PFA is associated with a significantly lower risk of phrenic nerve and esophageal injury than RFA and CBA.\n\n\n<\/jats:p>","DOI":"10.21542\/gcsp.2025.30","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T02:11:55Z","timestamp":1751249515000},"source":"Crossref","is-referenced-by-count":2,"title":["Phrenic nerve and esophageal injury in pulsed field ablation versus radiofrequency and cryoablation"],"prefix":"10.21542","volume":"2025","author":[{"given":"Sarah","family":"Shadiqa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Iqbal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giky","family":"Karwiky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaerul","family":"Achmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"8990","published-online":{"date-parts":[[2025,6,29]]},"container-title":["Global Cardiology Science and Practice"],"original-title":[],"link":[{"URL":"https:\/\/globalcardiologyscienceandpractice.com\/index.php\/gcsp\/article\/download\/816\/659","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/globalcardiologyscienceandpractice.com\/index.php\/gcsp\/article\/download\/816\/659","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T02:11:55Z","timestamp":1751249515000},"score":1,"resource":{"primary":{"URL":"https:\/\/globalcardiologyscienceandpractice.com\/index.php\/gcsp\/article\/view\/816"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,29]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,6,29]]}},"URL":"https:\/\/doi.org\/10.21542\/gcsp.2025.30","relation":{},"ISSN":["2305-7823"],"issn-type":[{"value":"2305-7823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,29]]}}}