Highlights the limitations of current catheter ablation techniques for atrial fibrillation, including suboptimal efficacy and rare but severe complications like atrioesophageal fistula, setting the stage for pulsed field ablation.
Catheter ablation for atrial fibrillation is an increasingly used and effective treatment for arrhythmia.1 However, catheter ablation remains limited on the basis of two broad issues. The first is efficacy rates that remain suboptimal and relatively stagnant despite the introduction of multiple new forms of technology and strategic approaches. Contemporary estimates of success at 1 year after ablation, as defined by the absence of medications, are 67 to 74% for paroxysmal atrial fibrillation2,3 and 43% for persistent and long-standing persistent atrial fibrillation.4 Second, relatively rare risks persist that can result in substantial complications and death. Of these, atrioesophageal fistula is . . .
T. Jared Bunch (Wed,) studied this question.