Progress in pulsed field ablation for atrial fibrillation and perioperative nursing strategies

Figure 1 The core mechanism of pulsed field ablation, which uses ultra-short, high-voltage electrical pulses to induce irreversible electroporation in myocardial cells. The process generates nanoscale pores in the cardiomyocyte membranes, disrupting calcium homeostasis and leading to programmed cell death (irreversible electroporation). It also demonstrates the tissue selectivity of pulsed field ablation, showing its higher sensitivity in myocardial cells compared to other tissues like the esophagus and nerves, preserving non-target structures.

Figure 2 The clinical advantages of pulsed field ablation for atrial fibrillation, including high acute efficacy, enhanced safety profile, and improved procedural efficiency. It highlights the mechanism of irreversible electroporation, the tissue selectivity in myocardial ablation, and the reduced collateral damage to surrounding tissues such as the esophagus and phrenic nerve. The figure also outlines key steps in the perioperative pathway for optimal patient outcomes. PFA: Pulsed field ablation; EF: Ejection fraction; HTN: Hypertension; LA: Left atrial; DM: Diabetes mellitus; CKD: Chronic kidney disease; DOACs: Direct oral anticoagulants; HR: Heart rate; BP: Blood pressure; SpO₂: Pulse oxygen saturation; ECG: Electrocardiogram; ACT: Activated clotting time; QoL: Quality of life; AF: Atrial fibrillation.

Figure 3 The perioperative nursing strategies essential for optimizing patient outcomes in atrial fibrillation ablation procedures, including pulsed field ablation. It covers preoperative risk assessment and education, intraoperative monitoring and complication prevention, and postoperative rehabilitation and health education. The figure emphasizes the importance of a comprehensive nursing approach to improving procedural success and long-term recovery. PFA: Pulsed field ablation; IRE: Irreversible electroporation.