Overcoming the Challenges of Transmural Durable Lesions With PFA—Impact of Electrode Design and Contact Assessment

Electrode design and reliable contact assessment are critical for creating durable pulsed field ablation (PFA) lesions to treat atrial fibrillation while minimizing collateral damage. This review introduces a novel "map-and-ablate" PFA catheter featuring flat electrodes, thermal contact assessment, and fully customizable electrode selection. We explore how electrode design impacts energy delivery and electric field direction, the importance of reliable contact assessment in ensuring lesion durability, and how customized electrode selection may minimize collateral damage.