# Evolving modalities of atrial fibrillation ablation: From thermal to nonthermal

## TL;DR

This paper reviews a new nonthermal ablation technique for treating atrial fibrillation using pulsed electrical fields, which may reduce complications and procedure time.

## Contribution

The paper introduces and explains pulsed field ablation as a novel nonthermal alternative to traditional thermal ablation methods for atrial fibrillation.

## Key findings

- Pulsed field ablation uses irreversible electroporation to target myocardial cells without damaging surrounding tissues.
- The technique shows potential for shorter procedures and fewer complications compared to radiofrequency or cryoablation.
- Clinical evidence and biophysics of the method are summarized for allied health professionals.

## Abstract

This review topic provides an overview of a novel technique for catheter ablation in patients with atrial fibrillation (AF) called pulsed field ablation. Pulsed field ablation uses a nonthermal vs thermal approach (radiofrequency or cryoablation) for obtaining myocardial cell death, which is referred to as irreversible electroporation for the treatment of AF via pulmonary vein isolation. This emerging technology delivers microsecond high-voltage electrical fields that may limit damage to tissues outside the myocardium and offers a promising approach to managing AF with shorter procedural times and fewer major complications. This review aimed to educate allied health professionals regarding this evolving technology by summarizing the biophysics of irreversible electroporation, clinical evidence supporting pulse field ablation, associated complications, and future applications.