Extrapulmonary Vein Areas with Pulsed Field Ablation: Is the Transition Completed?

Card Electrophysiol Clin

Division of Cardiology, Department of Biomedicine and Prevention, Policlinico Tor Vergata, Roma 00133, Italy; Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North Interstate Highway 35 Suite 700, Austin, TX 78705, USA. Electronic address:

Published: June 2025


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Article Abstract

Pulsed field ablation (PFA) is an innovative technology for the ablation of atrial fibrillation (AF), characterized by its ability to create tissue-selective lesions while minimizing collateral damage to surrounding structures. Isolation of the pulmonary veins (PVs) remains the cornerstone of AF ablation; however, recent evidence underscores the significance of extra-PV triggers, such as those from the posterior wall of the left atrium, the superior vena cava, the coronary sinus, and the left atrial appendage. While preliminary data suggest that PFA may enhance safety outcomes compared to traditional thermal techniques, further studies needed to validate its efficacy in non-PV areas.

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http://dx.doi.org/10.1016/j.ccep.2025.02.004DOI Listing

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