Kaddoura Rasha, Abushanab Dina, Asaad Nidal
Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Drug Information Center, Hamad Medical Corporation, Doha, Qatar.
Postgrad Med J. 2025 Jul 22;101(1198):690-703. doi: 10.1093/postmj/qgaf049.
This review investigated efficacy and safety of pulsed-field ablation (PFA) in comparison with radiofrequency ablation (RFA), cryoballoon ablation (CBA), or both combined. The Odds ratio (OR) and mean difference (MD) with 95% confidence interval (95% CI) were computed. PFA allowed shorter procedure (MD -44.27 minutes, 95% CI: -63.61; -24.93) and left atrium (LA) dwell (MD -32.71 minutes (95% CI: -58.64; -6.78) times, but with longer fluoroscopy time than RFA (MD 8.54 minutes, 95% CI: 4.03; 13.04). Post-procedural complications rate was lower with PFA than CBA (OR 0.53, 95% CI: 0.35, 0.80). Atrial arrhythmias recurrence rate within one year of follow-up was lower with PFA than RFA (OR 0.68, 95% CI; 0.53; 0.87) and CBA (OR 0.69, 95% CI: 0.48; 0.97). PFA allowed shorter procedure and LA dwell times, as well as lower atrial arrhythmia recurrence than RFA and lower post-procedural complications and atrial arrhythmias recurrence rates than CBA.
本综述研究了脉冲场消融（PFA）与射频消融（RFA）、冷冻球囊消融（CBA）或两者联合使用时的疗效和安全性。计算了比值比（OR）和平均差（MD）以及95%置信区间（95%CI）。PFA手术时间更短（MD -44.27分钟，95%CI：-63.61；-24.93），左心房（LA）停留时间更短（MD -32.71分钟，95%CI：-58.64；-6.78），但透视时间比RFA长（MD 8.54分钟，95%CI：4.03；13.04）。PFA术后并发症发生率低于CBA（OR 0.53，95%CI：0.35，0.80）。随访1年内，PFA导致的房性心律失常复发率低于RFA（OR 0.68，95%CI：0.53；0.87）和CBA（OR 0.69，95%CI：0.48；0.97）。与RFA相比，PFA手术时间和LA停留时间更短，房性心律失常复发率更低；与CBA相比，PFA术后并发症和房性心律失常复发率更低。
