Pulsed Field Ablation (PFA) for Pulmonary Vein Isolation in τhe Treatment οf Atrial Fibrillation

Pulsed Field Ablation


  • Sokratis Pastromas Henry Dunant Hospital


Pulsed‐field ablation (PFA) is a promising new ablation modality for the treatment of atrial fibrillation (AF). Pulmonary vein isolation (PVI) remains the most frequently used treatment strategy of any AF ablation procedure. A major limitation of current catheter ablation procedures is PVI reconnection, reported to be about 20% of patients. Pulsed field ablation is a novel energy source by which high-voltage electric pulses are used to create pores in the cellular membrane (i.e., electroporation), leading to cellular death. The amount of energy required to produce irreversible electroporation is highly tissue dependent reducing the risk of damage to surrounding non-cardiac tissues. The tissue specificity of PFA may result in a wide therapeutic range and improved safety profile during atrial fibrillation ablation. There has been no evidence of incidental phrenic nerve injury, and finally, PFA has been shown not to injure esophageal tissue when directly applied to the esophagus or indirectly through ablation in the left atrium. Rhythmos 2022;17(4): 75-78.