Pulsed field ablation for atrial fibrillation demonstrates comparable efficacy to radiofrequency and cryoballoon ablation, with advantages in safety and efficiency.
This international scientific statement provides comprehensive guidance on the biophysics, clinical evidence, workflow, and safety of pulsed field ablation for the interventional treatment of atrial fibrillation.
Pulsed field ablation has emerged as a novel non-thermal treatment modality with a distinct safety profile for the interventional treatment of atrial fibrillation. By inducing irreversible electroporation, pulsed field ablation achieves myocardial ablation while preserving surrounding structures such as nerves, vasculature, and the esophagus. This European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC) scientific statement, endorsed by major international societies, reviews the biophysics, technology, clinical evidence, workflow, safety, and training aspects of pulsed field ablation. Randomized trials demonstrate comparable efficacy to radiofrequency and cryoballoon ablation, with advantages in safety and efficiency. The statement provides practical advice for clinical implementation, operator training, and identifies key gaps in evidence and priorities for future research and innovation.
Kühne et al. (2026) conducted a review in Atrial fibrillation. Pulsed field ablation vs. Radiofrequency and cryoballoon ablation was evaluated. Pulsed field ablation for atrial fibrillation demonstrates comparable efficacy to radiofrequency and cryoballoon ablation, with advantages in safety and efficiency.