International scientific statement from EHRA, HRS, APHRS, LAHRS and CHRS on pulsed field ablation (PFA) for atrial fibrillation. Through irreversible electroporation, PFA achieves myocardial ablation while preserving surrounding structures such as nerves, vasculature and the esophagus. Randomized trials demonstrate efficacy comparable to radiofrequency and cryoballoon ablation, with clear advantages in safety and procedural efficiency. The statement summarizes biophysics, technology and clinical evidence and provides practical guidance for clinical implementation and operator training.
Pulsed field ablation has emerged as a novel non-thermal treatment modality with a distinct safety profile for the interventional treatment of atrial fibrillation. By inducing irreversible electroporation, pulsed field ablation achieves myocardial ablation while preserving surrounding structures such as nerves, vasculature, and the esophagus. This European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC) scientific statement, endorsed by major international societies, reviews the biophysics, technology, clinical evidence, workflow, safety, and training aspects of pulsed field ablation. Randomized trials demonstrate comparable efficacy to radiofrequency and cryoballoon ablation, with advantages in safety and efficiency. The statement provides practical advice for clinical implementation, operator training, and identifies key gaps in evidence and priorities for future research and innovation.
