A meta-analysis comparing pulsed-field ablation (PFA) and thermal ablation (TA) for atrial fibrillation (AF) found that PFA was associated with shorter procedural times but longer fluoroscopy times compared to TA. PFA showed better first-pass isolation rates and lower treatment failure rates than TA. However, PFA was linked to higher tamponade rates and lower (peri-)esophageal injury rates. Subgroup analyses revealed no significant differences in efficacy or safety between paroxysmal and persistent AF. The cryoballoon subgroup had higher (peri-)esophageal injury rates and lower acute success compared to the radiofrequency group. PFA demonstrated better short- and long-term efficacy but had significant safety differences, with lower esophageal injury but higher tamponade rates. The study concluded that PFA is a promising alternative to TA for AF, though further research is needed to fully understand its long-term safety and effectiveness.A meta-analysis comparing pulsed-field ablation (PFA) and thermal ablation (TA) for atrial fibrillation (AF) found that PFA was associated with shorter procedural times but longer fluoroscopy times compared to TA. PFA showed better first-pass isolation rates and lower treatment failure rates than TA. However, PFA was linked to higher tamponade rates and lower (peri-)esophageal injury rates. Subgroup analyses revealed no significant differences in efficacy or safety between paroxysmal and persistent AF. The cryoballoon subgroup had higher (peri-)esophageal injury rates and lower acute success compared to the radiofrequency group. PFA demonstrated better short- and long-term efficacy but had significant safety differences, with lower esophageal injury but higher tamponade rates. The study concluded that PFA is a promising alternative to TA for AF, though further research is needed to fully understand its long-term safety and effectiveness.