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As pulsed-field ablation (PFA) emerges as a promising therapy for atrial arrhythmias, an understanding of the cellular injury to cardiac tissue is critical to evaluating and interpreting results for each PFA system. This review aims to detail the mechanism of cell death for PFA, compare the cell death mechanism to thermal ablation modalities, clarify common histology markers, detail the progression of PFA lesions from the acute, to subacute, to chronic maturation states, and discuss clinical indicators of PFA lesions.
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http://dx.doi.org/10.1111/pace.15154 | DOI Listing |
Europace
September 2025
Department of Cardiology and Vascular Medicine, University Heart and Vascular Center Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.
Background And Aims: Aim of this study was to assess the risk of hemolysis, the extent of myocardial and neural injury after monopolar, monophasic pulsed field ablation (PFA) using a lattice-tip catheter in comparison to single-shot PF ablation platforms employing bipolar, biphasic waveforms.
Methods: This prospective study included consecutive patients undergoing PFA for atrial fibrillation (AF) using the Affera™ mapping and ablation system (n=40). Biomarkers for hemolysis (haptoglobin, LDH, bilirubin), myocardial injury (high-sensitive troponin T, CK, CK-MB), neurocardiac injury (S100), and renal function (creatinine) were assessed pre- and within 24 hours post-ablation.
Kardiol Pol
September 2025
Department of Cardiology, Stefan Cardinal Wyszynski Province Specialist Hospital, Lublin, Poland.
Eur Heart J Case Rep
September 2025
Clinical Electrophysiology, St. Joseph's Heart Rhythm Center, Anny Jagiellonki 17, 35-623 Rzeszów, Poland.
Background: Premature ventricular contractions (PVCs) originating from the infundibular region of the right ventricular outflow tract (RVOT) may be challenging to ablate due to thin myocardial wall and proximity to the coronary arteries in this region. In such anatomically sensitive regions, the use of radiofrequency (RF) energy may carry a risk of collateral injury or prove ineffective. We present a case report describing successful ablation of infundibular PVCs using pulsed field ablation (PFA).
View Article and Find Full Text PDFHeart Rhythm O2
August 2025
Heart Rhythm Center, Department of Cardiovascular Medicine, Sendai Kosei Hospital, Tsutsumidori-Amamiyamachi, Aoba-ku, Sendai-shi, Miyagi, Japan.
Heart Rhythm O2
August 2025
Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York.