Pulsed field ablation: focused on atrial fibrillation ablation

Atrial fibrillation (AF) is the most common sustained tachyarrhythmia and its increasing prevalence has resulted in a growing healthcare burden. Catheter ablation is indicated for patients with AF who are either refractory or intolerant to antiarrhythmic drugs or who exhibit decreased left ventricular systolic function. Catheter ablation can be categorized based on the energy source used, including radiofrequency ablation (RFA), cryoablation, laser ablation, and the recently emerging pulsed field ablation (PFA). PFA is anticipated to be promising owing to its tissue specificity, resulting in less collateral damage than thermal energy catheter ablations, such as RFA and cryoablation. In this review, we summarize the biophysical principles and clinical applications of PFA, highlighting its safety and efficacy profile compared to that with conventional thermal ablation.