Practical Guide on the Use of the PulseSelect Pulsed Field Ablation System for Atrial Fibrillation Ablation Procedures

Pulsed field ablation (PFA), which employs intermittent short-duration high-voltage electrical impulses to induce cellular membrane pore formation, is one of the most substantial innovations in the field of cardiac electrophysiology. In contrast to thermal ablation using radiofrequency or cryoenergy, PFA is theoretically capable of preferential tissue destruction, avoiding the negative effects of thermal energy and minimizing the risk of collateral damage. The optimal use of PFA requires operators to adapt their procedural approach to the novel catheter and energy source. The purpose of this manuscript is to summarize the best practice procedural considerations related to PFA with the PulseSelect ablation catheter, within the context of the contemporary evidence-base and with a focus on a predominantly fluoroscopy-based workflow. A foundational approach to pulmonary vein isolation with the PulseSelect catheter would reduce procedural heterogeneity, ultimately improving patient outcomes through the adoption of standardized evidence-based practices.