Pulsed Field Ablation in the Treatment of Cardiac Arrhythmias: A State-of-the-art Review

Abstract Pulsed-field ablation (PFA), specifically irreversible electroporation, induces cell membrane damage through the formation of irreversible pores, leading to apoptosis and necrosis, with applications in tumor treatment and myocardium ablation since 2007. This review is on PFA in the treatment of cardiac arrhythmias, including the basic principles, clinical applications, and hot issues of PFA. Presently, the pulsed electric field has demonstrated its effectiveness and safety in the treatment of atrial fibrillation, which is not inferior to that of traditional thermal energy. Research and application on pulsed electric ablation is rapidly advancing due to its advantages of rapidity and specificity in lesion creation. Moreover, pulsed electric ablation has reduced the difficulty of catheter manipulation in pulmonary vein isolation, making it an available treatment to benefit more patients.