Pulsed Field Ablation for Atrial Fibrillation: Mechanisms, Advantages, and Limitations.

Rev Cardiovasc Med

Department of Cardiovascular Medicine, Second Xiangya Hospital, Central South University, 410011 Changsha, Hunan, China.

Published: April 2024

AI Article Synopsis

  • * Clinical trials have demonstrated PFA's effectiveness in isolating pulmonary veins in patients with both paroxysmal and persistent atrial fibrillation, making it a quick and straightforward method that reduces the risk of iatrogenic (treatment-related) injuries.
  • * The paper reviews the mechanisms, benefits, and drawbacks of PFA, highlighting how adjustments in ablation parameters can impact treatment outcomes and suggesting future research directions.

Article Abstract

Pulsed field ablation with irreversible electroporation for the treatment of atrial fibrillation involves tissue-specific and non-thermal energy-induced cell necrosis, which helps avoid complications, such as pulmonary vein stenosis, atrial collateral tissue damage, and extensive atrial structural damage, often encountered with traditional thermal ablation. In existing clinical trials, pulsed field ablation has shown excellent effects on pulmonary vein isolation in patients with paroxysmal and persistent atrial fibrillation. Pulsed field ablation is easy, simple, and quick and can reduce iatrogenic injury. Therefore, the application of pulsed field ablation technology in the treatment of atrial fibrillation has a promising future. Notably, the adjustment of parameters in pulsed field ablation with different ablation catheter systems can strongly affect the area and depth of the necrotic myocardium, which greatly affects the likelihood of atrial fibrillation recurrence and incidence of adverse complications after ablation. In this paper, we review the mechanisms, advantages, and limitations of pulsed field ablation based on the results of a series of previous studies and provide ideas and directions for future research.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264014PMC
http://dx.doi.org/10.31083/j.rcm2504138DOI Listing

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