Work

Comparative efficacy and safety of catheter ablation technologies for atrial fibrillation: a systematic review and network meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Aims: There are several interventional approaches to atrial fibrillation (AF) ablation; however, it is not yet known which procedure is most effective. Our aim was to compare the efficacy and safety of different interventional approaches for the treatment of AF through network meta-analysis. Methods: We searched randomized controlled trial (RCT) and propensity-score matched (PSM) studies in PubMed, Embase, and Cochrane Library databases from the initial period to December 2024, and studies were selected which had cryoballoon ablation (CBA), conventional radiofrequency ablation (RFA), remote magnetic navigation ablation (RMN), and pulsed field ablation (PFA) as an arm in the study. Network meta-analysis (NMA) was performed using a frequentist approach with STATA (version 14.0) software. Results: We included 10 RCT studies and 4 PSM studies. For freedom from AF and other atrial tachyarrhythmias (AT) indicators, PFA may become the most effective ablation procedure (SUCRA = 88.4%, RR = 1.11, 95% CI: 1.03-1.21). For procedure duration, PFA may also be the ablation procedure with the best results (SUCRA = 91.2%, SMD = -1.43, 95% CI: -2.47 to -0.39). Conclusion: The choice of ablation technique needs to be weighed against the specific clinical needs and the patient's situation. PFA may be the best choice if success rate and procedure time are prioritized, while RMN is more appropriate if complication rates and fluoroscopy time are more important. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42025631158, identifier: CRD42025631158.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2026.1667194

Authors: Ruiting Feng, Jia Gao, Yajie Guo, Yuli Guo, Rui Wang, Min Guo

Institutions: Shanxi Medical University, First Hospital of Shanxi Medical University

Language: English

Topic: Atrial Fibrillation Management and Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801