Kars Neven, Anna Füting, Stefan Hartl, Nico Reinsch
Pulsed field ablation (PFA) represents a paradigm shift in the catheter-based treatment of AF, offering myocardial-selective ablation through the non-thermal mechanism of irreversible electroporation. Despite promising early outcomes, the durability of PFA lesions, particularly over mid-and long-term follow-up, remains a critical area of investigation. This review incorporates preclinical and clinical data on PFA lesion durability, explores biophysical underpinnings, evaluates procedural variables influencing outcomes, and identifies ongoing challenges and future research priorities.