Key result
Focal PFA linked to transient AV block when applied near conduction structures.
Why the study?
Focal pulsed field ablation is emerging for arrhythmia treatment, but its potential to cause conduction system damage requires evaluation.
Focal pulsed field ablation carries a risk of transient atrioventricular block, necessitating caution when ablating near the conduction system.
Warrants caution near the conduction system with focal PFA; hypothesis-generating and requires prospective studies before routine adoption.**[[1]](https://www.sciencedirect.com/science/article/abs/pii/S1547527124033198)[[2]](https://onlinelibrary.wiley.com/doi/10.1111/pace.
Pulsed field ablation (PFA) is being adopted into widespread use worldwide for the treatment of a wide range of arrhythmias, with attractive tissue selectivity and safety profiles. While single‐shot PFA remains the mainstay of atrial ablation at present, focal applications of PFA are emerging as a highly effective means of delivering effective ablation. The present case illustrates transient atrioventricular block following PFA, highlighting potential for conduction system damage with PFA and supporting a cautious approach in close proximity to conduction system structures.
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Spath et al. (2026) studied this question. Focal pulsed field ablation can cause transient atrioventricular block, highlighting the risk of conduction system damage when applied in close proximity to these structures.
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