• Pulsed field ablation (PFA) is a promising alternative to conventional radiofrequency and cryoballoon ablation, causing selective myocardial electroporation.
• Clinical trial evidence demonstrates comparable efficacy to existing ablation modalities and a favourable short-term safety profile.
• PFA enables faster procedures, but the requirement for general anesthesia and higher procedural costs may limit widespread adoption.
• There is need for caution as longer term safety data and previously unreported complications emerge.
Catheter-based pulmonary vein isolation (PVI) is an established and effective treatment for symptomatic atrial fibrillation (AF), demonstrating superiority over antiarrhythmic drug therapy in maintaining sinus rhythm and improving symptoms (1–2).
Despite three decades of progress since the advent of PVI, two principal concerns remain. First, approximately one in three patients experience recurrence of atrial arrhythmias within one year of the procedure (3). Second, current ablation techniques employ radiofrequency or cryothermal energy, which may cause indiscriminate tissue injury to surrounding structures such as the oesophagus and phrenic nerve. Although infrequent, this can result in serious complications – in some cases leading to death (4–7).
Authors Heartbeat Sub-Editor: Sandeep Singh Dr Sandeep Singh is a Cardiology Clinical Fellow at Nottingham University Hospitals NHS Trust. After graduating from India, he completed
Authors Heartbeat Sub-Editor: Khin Kay Kay Kyaw I am currently working as cardiology specialist registrar ST6 at southwest peninsula region while also working as an
Authors Heartbeat Sub-Editor: Anindya Mukherjee Dr. Anindya Mukherjee is a ST5 trainee registrar in Cardiology at Mid Yorkshire Teaching NHS Trust, UK, with extensive experience
Authors Sub-editor: Sameer Zaman Heartbeat Sub-Editor: Aleena Haider Aleena is an academic cardiology trainee at Imperial College London with a strong commitment to all aspects
Authors Sub-editor: Sameer Zaman Heartbeat Sub-Editor: Padraig O Drisceoil Dr Pádraig Ó Drisceoil is a Cardiology Speciality Trainee from the Wessex Deanery, who is currently an
