Pulsed field catheter ablation in atrial fibrillation

Luigi Di Biase, Juan Carlos Diaz, Xiao Dong Zhang, Jorge Romero

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations


Catheter ablation (CA) has become the mainstay therapy for the maintenance of sinus rhythm in patients with atrial fibrillation (AF), with pulmonary vein isolation (PVI) the most frequently used treatment strategy. Although several energy sources have been tested (including radiofrequency, cryothermal and laser), these are not devoid of safety issues and in many instances effectiveness is dependent on operator experience. Pulsed field ablation (PFA) 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. In consequence, a tailored protocol in which specific targeting of the atrial myocardium is achieved while sparing adjacent tissues is theoretically feasible, increasing the safety of the procedure. While large scale clinical trials are lacking, current clinical evidence has demonstrated significant efficacy in achieving durable PVI without ablation related adverse events.

Original languageEnglish (US)
Pages (from-to)378-387
Number of pages10
JournalTrends in Cardiovascular Medicine
Issue number6
StatePublished - Aug 2022


  • Atrial fibrillation
  • Complications
  • Cryoenegy
  • Electroporation
  • Energy source
  • Pulsed field ablation
  • Radio-frequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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