Michael Kühne, Patrick Badertscher, Jason G. Andrade, Ante Anić, JKR Chun, Antonio Dello Russo, Pierre Jaı̈s, Josef Kautzner, Heiko Lehrmann, Claire A Martin, Jose Luis Merino, Damijan Miklavčič, Andrea Natale, Kars Neven, Armando Pérez-Silva, Jonathan P. Piccini, Tobias Reichlin, Raphaël Rosso, Martin H. Ruwald, Andrea Sarkozy, Daniel Scherr, Arian Sultan, Hiroshi Tada, Stylianos Tzeis, Atul Verma, Bradley Wilsmore, Helmut Pürerfellner
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 oesophagus. This European Heart Rhythm Association of the European Society of Cardiology 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 and operator training and identifies key gaps in evidence and priorities for future research and innovation.