Alternative options to thermal ablation for atrial fibrillation: the role of pulsed field ablation in reducing complications and maintaining efficacy

PFA promises to overcome the safety limitations encountered during AF ablation with thermal modalities. This may permit earlier referrals, treatment of more complex patients, and adoption of a more individualized, extensive ablation approach. Despite this, PFA still requires technological and workflow optimization due to challenges in lesion durability, real-time lesion assessment, and emerging concerns about energy-specific side effects. These issues require operator awareness and are expected to be addressed with second-generation PFA systems.