What does pulsed-field ablation (PFA) involve?

PFA uses ultra-short, high-voltage electrical pulses to create irreversible pores in cardiac tissue cells, selectively ablating arrhythmogenic myocardium while sparing surrounding structures like the esophagus and phrenic nerve. Unlike thermal ablation (radiofrequency or cryo), it is non-thermal and tissue-selective, reducing collateral damage. The procedure is performed via catheter access through the femoral vein, typically under conscious sedation or general anesthesia, and lasts 60–90 minutes. Most patients are discharged within 24–48 hours.