Comparative Studies of Different Ablation Techniques for Atrial Fibrillation

Atrial fibrillation (AF) is the most common supraventricular arrhythmia, affecting 2–3% of the adult population, with an increasing prevalence due to demographic shifts; however, detection methods have also improved. This rhythm disorder is associated with significant morbidity, manifesting through...

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Main Authors: Monika Keževičiūtė, Germanas Marinskis, Diana Sudavičienė, Jūratė Barysienė, Neringa Bileišienė, Greta Radauskaitė, Audrius Aidietis, Gediminas Račkauskas
Format: Article
Language:English
Published: IMR Press 2025-05-01
Series:Reviews in Cardiovascular Medicine
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Online Access:https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM33490
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author Monika Keževičiūtė
Germanas Marinskis
Diana Sudavičienė
Jūratė Barysienė
Neringa Bileišienė
Greta Radauskaitė
Audrius Aidietis
Gediminas Račkauskas
author_facet Monika Keževičiūtė
Germanas Marinskis
Diana Sudavičienė
Jūratė Barysienė
Neringa Bileišienė
Greta Radauskaitė
Audrius Aidietis
Gediminas Račkauskas
author_sort Monika Keževičiūtė
collection DOAJ
description Atrial fibrillation (AF) is the most common supraventricular arrhythmia, affecting 2–3% of the adult population, with an increasing prevalence due to demographic shifts; however, detection methods have also improved. This rhythm disorder is associated with significant morbidity, manifesting through symptoms that worsen the quality of life, as well as with adverse outcomes and increased mortality. The substantial AF burden on the healthcare system necessitates the development of effective and durable treatment strategies. While pharmacological management represents the first-line approach for AF, the limitations associated with this approach, including side effects and insufficient efficacy, have promoted the evolution of catheter ablation techniques that isolate pulmonary veins (PVs) and, thus, disrupt arrhythmia-causing impulses from the atria. Currently, three energy sources have gained U.S. Food and Drug Administration (FDA) and European regulatory approval (The Conformité Européene (CE) mark certification) for catheter ablation: radiofrequency ablation (RFA), cryoballoon ablation (CBA), and, more recently, pulsed-field ablation (PFA). RFA has subsequently become an effective treatment, demonstrating superior outcomes in randomized controlled trials compared to antiarrhythmic drug therapy. CBA has also proven to be a safe and effective alternative, particularly for patients with symptomatic paroxysmal AF, showing comparable efficacy to RFA and similar rates of complications. Meanwhile, PFA is emerging as a promising technique, offering non-inferior efficacy to conventional thermal methods while potentially minimizing the thermal damage to adjacent tissues associated with RFA and CBA. Despite higher equipment costs, the advantages of PFA in reducing complications highlight its potential role in AF management. However, considering the novelty of PFA, no data currently exist comparing this strategy with thermal techniques. Therefore, further research is needed to improve the management of AF and patient outcomes to reduce healthcare burdens.
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spelling doaj-art-44da867505f74b6c9be4b89502befba22025-08-20T02:03:25ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-05-012653349010.31083/RCM33490S1530-6550(25)01813-7Comparative Studies of Different Ablation Techniques for Atrial FibrillationMonika Keževičiūtė0Germanas Marinskis1Diana Sudavičienė2Jūratė Barysienė3Neringa Bileišienė4Greta Radauskaitė5Audrius Aidietis6Gediminas Račkauskas7Department of Cardiovascular Medicine, Faculty of Medicine, Vilnius University, LT-0310 Vilnius, LithuaniaDepartment of Cardiovascular Medicine, Faculty of Medicine, Vilnius University, LT-0310 Vilnius, LithuaniaDepartment of Cardiovascular Medicine, Faculty of Medicine, Vilnius University, LT-0310 Vilnius, LithuaniaDepartment of Cardiovascular Medicine, Faculty of Medicine, Vilnius University, LT-0310 Vilnius, LithuaniaDepartment of Cardiovascular Medicine, Faculty of Medicine, Vilnius University, LT-0310 Vilnius, LithuaniaDepartment of Cardiovascular Medicine, Faculty of Medicine, Vilnius University, LT-0310 Vilnius, LithuaniaDepartment of Cardiovascular Medicine, Faculty of Medicine, Vilnius University, LT-0310 Vilnius, LithuaniaDepartment of Cardiovascular Medicine, Faculty of Medicine, Vilnius University, LT-0310 Vilnius, LithuaniaAtrial fibrillation (AF) is the most common supraventricular arrhythmia, affecting 2–3% of the adult population, with an increasing prevalence due to demographic shifts; however, detection methods have also improved. This rhythm disorder is associated with significant morbidity, manifesting through symptoms that worsen the quality of life, as well as with adverse outcomes and increased mortality. The substantial AF burden on the healthcare system necessitates the development of effective and durable treatment strategies. While pharmacological management represents the first-line approach for AF, the limitations associated with this approach, including side effects and insufficient efficacy, have promoted the evolution of catheter ablation techniques that isolate pulmonary veins (PVs) and, thus, disrupt arrhythmia-causing impulses from the atria. Currently, three energy sources have gained U.S. Food and Drug Administration (FDA) and European regulatory approval (The Conformité Européene (CE) mark certification) for catheter ablation: radiofrequency ablation (RFA), cryoballoon ablation (CBA), and, more recently, pulsed-field ablation (PFA). RFA has subsequently become an effective treatment, demonstrating superior outcomes in randomized controlled trials compared to antiarrhythmic drug therapy. CBA has also proven to be a safe and effective alternative, particularly for patients with symptomatic paroxysmal AF, showing comparable efficacy to RFA and similar rates of complications. Meanwhile, PFA is emerging as a promising technique, offering non-inferior efficacy to conventional thermal methods while potentially minimizing the thermal damage to adjacent tissues associated with RFA and CBA. Despite higher equipment costs, the advantages of PFA in reducing complications highlight its potential role in AF management. However, considering the novelty of PFA, no data currently exist comparing this strategy with thermal techniques. Therefore, further research is needed to improve the management of AF and patient outcomes to reduce healthcare burdens.https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM33490atrial fibrillationradiofrequency ablationcryoablatiobnpulsed fieldablationpulmonary vein isolation
spellingShingle Monika Keževičiūtė
Germanas Marinskis
Diana Sudavičienė
Jūratė Barysienė
Neringa Bileišienė
Greta Radauskaitė
Audrius Aidietis
Gediminas Račkauskas
Comparative Studies of Different Ablation Techniques for Atrial Fibrillation
Reviews in Cardiovascular Medicine
atrial fibrillation
radiofrequency ablation
cryoablatiobn
pulsed fieldablation
pulmonary vein isolation
title Comparative Studies of Different Ablation Techniques for Atrial Fibrillation
title_full Comparative Studies of Different Ablation Techniques for Atrial Fibrillation
title_fullStr Comparative Studies of Different Ablation Techniques for Atrial Fibrillation
title_full_unstemmed Comparative Studies of Different Ablation Techniques for Atrial Fibrillation
title_short Comparative Studies of Different Ablation Techniques for Atrial Fibrillation
title_sort comparative studies of different ablation techniques for atrial fibrillation
topic atrial fibrillation
radiofrequency ablation
cryoablatiobn
pulsed fieldablation
pulmonary vein isolation
url https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM33490
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