Current status of pulsed electric field ablation for atrial fibrillation

Catheter ablation (CA) has become one of the main methods for treating patients with medically refractory AF at home and abroad and pulmonary vein isolation (PVI) is the most important cornerstone of CA. There are still irreversible safety problems such as phrenic nerve injury, atrial esophageal fistula and pericardial tamponade, both in impedance thermal injury of catheter and cryoablation of balloon. Pulsed field ablation (PFA), as a new type of electrical impulse energy, is a hotspot in the treatment of arrhythmia. Its principle is that short-duration and high-voltage electrical impulse energy is released to irreversible electroporation of cells, resulting in cell apoptosis and causing irreversible damage to the heart muscle, thereby isolating the pulmonary veins. It can protect coronary artery, esophagus, pulmonary vein, phrenic nerve and other surrounding tissues from injury, and is more effective and safe than conventional ablation in the process of pulmonary vein isolation in atrial fibrillation. In this paper, the characteristics of pulsed electric field ablation are reviewed and its advantages in the treatment of atrial fibrillation are explained.