Cristiano E, Ali H, Celentano E, Cappato R. Catheter ablation using pulsed-field energy: Do we finally have the magic wand to defeat atrial fibrillation? World J Cardiol 2024; 16(12): 677-682 [DOI: 10.4330/wjc.v16.i12.677]
Corresponding Author of This Article
Hussam Ali, MD, FESC, Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni 20099, Milan, Italy. hussamali.ep@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ernesto Cristiano, Eduardo Celentano, Department of Cardiac Electrophysiology Complex Operational Unit, Humanitas Gavazzeni, Bergamo 24125, Lombardy, Italy
Hussam Ali, Riccardo Cappato, Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni 20099, Milan, Italy
Eduardo Celentano, Department of Cardiology, Erasmus University Medical Center, Rotterdam 3090, Netherlands
Author contributions: Cristiano E and Ali H contributed to the conceptualization and drafting of the manuscript; Celentano E and Cappato R provided scientific supervision and formal review of the text; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hussam Ali, MD, FESC, Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni 20099, Milan, Italy. hussamali.ep@gmail.com
Received: May 28, 2024 Revised: September 28, 2024 Accepted: October 25, 2024 Published online: December 26, 2024 Processing time: 181 Days and 12.1 Hours
Abstract
Clinical outcomes of catheter ablation remain suboptimal in patients with atrial fibrillation (AF), particularly in those with persistent AF, despite decades of research, clinical trials, and technological advancements. Recently, pulsed-field ablation (PFA), a promising non-thermal technology, has been introduced to improve procedural outcomes. Its unique feature of myocardial selectivity offers safety advantages by avoiding potential harm to vulnerable adjacent structures during AF ablation. However, despite the global enthusiasm within the electrophysiology community, recent data indicate that PFA is still far from being a “magic wand” for addressing such a complex and challenging arrhythmia as AF. More progress is needed in mapping processes rather than in ablation technology. This editorial reviews relevant available data and explores future research directions for PFA.
Core Tip: Pulse-field ablation is an emerging technology in the field of arrhythmia ablation based on electroporation method, particularly adopted for atrial fibrillation. While there is growing interest in the safety and efficacy of catheter ablation using electroporation, several aspects of its long-term effectiveness and procedural limitations require further investigation before pulse-field ablation can be considered a definitive solution for atrial fibrillation.
