Interv Akut Kardiol. 2023;22(3):145-150 | DOI: 10.36290/kar.2023.022

Technology of catheter ablation of atrial fibrillation using pulsed field

Martin Mudroch, Štěpán Královec, Jan Petrů, Petr Neužil

Nemocnice Na Homolce, Praha

Catheter ablation of atrial fibrillation using radiofrequency energy has been the gold standard until these days. Nevertheless, there are limitations associated with the application of thermal energy such as damage to collateral structures, time-consuming nature, and, in particular, frequent recurrences of both atrial fibrillation and atrial tachycardias. Therefore, it was essential to find a brand new method with a better safety and efficiency profile. Promising results have been obtained with methods using pulsed field based on the principles of irreversible electroporation which, in comparison with the methods used so far that have a thermal effect and induce coagulation necrosis, predominantly cause disintegration of the cell membrane. This article deals with the principle of electroporation, pathophysiological background, and technical specification of the development of ablation systems using pulsed field energy. Also presented are the results of initial clinical trials with ablation treatment of all types of atrial fibrillation using the pulsed field method as well as the initial experience from the practice.

Keywords: atrial fibrillation, catheter ablation, electroporation, pulsed field ablation.

Received: March 3, 2023; Revised: May 4, 2023; Accepted: May 11, 2023; Published: November 7, 2023  Show citation