Novel methodology for nonfluoroscopic wire visualization during pulsed field ablation for the treatment of atrial fibrillation

Pulsed field ablation (PFA) is a novel non-thermal ablation modality for the treatment of atrial fibrillation (AF). 1 Verma A. Boersma L. Haines D.E. et al. First-in-Human Experience and Acute Procedural Outcomes Using a Novel Pulsed Field Ablation System: The PULSED AF Pilot Trial. Circulation: Arrhythmia and Electrophysiology. 2022; 15e010168https://doi.org/10.1161/CIRCEP.121.010168 Google Scholar , 2 Verma A. Haines D.E. Boersma L.V. et al. Pulsed Field Ablation for the Treatment of Atrial Fibrillation: PULSED AF Pivotal Trial. Circulation. 2023; 147: 1422-1432https://doi.org/10.1161/CIRCULATIONAHA.123.063988 Google Scholar , 3 Reddy V.Y. Gerstenfeld E.P. Natale A. et al. Pulsed Field or Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation. N Engl J Med. 2023; 389: 1660-1671https://doi.org/10.1056/NEJMoa2307291 Google Scholar PFA is associated with shorter procedure times compared to radiofrequency ablation (RFA) with similar efficacy. However, fluoroscopic times are longer due to a lack of optimized electro-anatomical (EAM) mapping systems. 3 Reddy V.Y. Gerstenfeld E.P. Natale A. et al. Pulsed Field or Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation. N Engl J Med. 2023; 389: 1660-1671https://doi.org/10.1056/NEJMoa2307291 Google Scholar We describe a novel approach for non-fluoroscopic wire visualization using EAM during PFA.