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Pulse field ablation

Heart Rhythm Conditions | Last Active: 15 hours ago | Replies (51)

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Profile picture for sjm46 @sjm46

@wews If PFA has a 85% success rate, who wouldn't take those chances? As for "not superior" in results, that doesn't mean it isn't just as good and it is safer! I am more than happy I insisted on PFA.

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Replies to "@wews If PFA has a 85% success rate, who wouldn't take those chances? As for "not..."

@sjm46 The point is that it does not have a 85% success rate because, as the citation says, it is no better (currently) than RF, and RF ablation only has a 75% success rate (some sources saying it is lower, closer to 68%). If RF has a 70-75% success rate, and the citation is correct, that PFA is not significantly (statistically) superior to RF, then PFA cannot have an 85% success rate. QED.
https://biologyinsights.com/what-is-the-afib-ablation-success-rate/
This study is actually quite dismal, indicating only 56% success for first ablations:
https://www.sciencedirect.com/science/article/abs/pii/S0146280622000585
This one says it's closer to 90%:
https://medtigo.com/news/refined-rf-based-ablation-techniques-show-high-success-rates-for-treating-afib/
Whatever you want to pin it at, say an average of about 75%, the first citation in the previous post says that PFA is not statistically more efficacious than RF. What PFA does have is less risk due to less tissue damage, or potential damage to the phrenic nerve and to the esophagus. That, alone would make PFA more desirable for the majority of patients. Just don't expect to be AF-free at a rate higher than RF, where the failure rate runs at about 25%.