Solving the problem of durable pulmonary vein isolation by targeted pulmonary vein sleeve “ablation” with pulsed fields

Electrical silencing of PVs is the bedrock of atrial fibrillation (AF) ablation and is currently achieved using a technique widely referred to as PV isolation (PVI). This represents the culmination of several strategies that aim to achieve a balance between efficacy and safety. Thermal ablation within the PVs was initially used to target PV triggers, however this was limited by poor efficacy and PV stenosis.1,2 This led to the adoption of segmental ostial ablation, allowing operators to avoid ablation deep within the PVs.