Pulsed field electroporation for pulmonary vein isolation—continued innovation to improve our atrial fibrillation armamentarium

Excerpt

Atrial fibrillation (AF) is the most common arrhythmia plaguing our patients. The search for enhanced efficacy and safety in pulmonary vein isolation (PVI) remains an ongoing struggle. Current catheter-based treatment modalities are overwhelmingly thermal based, including radiofrequency (RF) and cryoablation (cryo). These approaches have efficacy concerns related to difficulty in creating contiguous and durable lesions, which leads to PV reconnection and AF recurrence. Thermal ablation also poses a risk for esophageal and phrenic nerve damage. Pulsed field electroporation ablation (PFA) is a novel technique that utilizes short bursts of high voltage. This leads to cellular membrane disruption via pore formation and results in cellular and tissue destruction with enhanced tissue selectivity [1]. Given the potential advantages in both efficacy and safety, there has been a robust effort to design novel catheters and delivery systems to utilize this exciting innovation. …