Cardiac Pulsed-Field Ablation
Non-Oncological Applications
Cardiac pulsed-field ablation uses irreversible electroporation to treat atrial fibrillation and is the largest clinical application of electroporation outside oncology. Its tissue selectivity, sparing adjacent structures such as the oesophagus and phrenic nerve, is the same property sought in tumour ablation. This area falls outside the oncological scope of the portal and does not appear in the indication landscape; it is kept in the corpus as context.
135total publications
54clinical studies
26preclinical studies
39reviews
2007–2026publication span
Evidence Status by Regime
Irreversible electroporation (IRE-ECT)
135publications
54clinical
26preclinical
Clinical Evidence
2007–2026 · In Routine Clinical Use
Mechanisms Reported in This Area
Terms were detected by automatic matching over publication abstracts; the figure gives the number of publications containing the term.
Irreversible Pore Formation and Cell Death 133
Preservation of Nerve and Vascular Structures 30
Reversible Membrane Permeabilisation 29
Muscle Contraction and Anaesthesia Requirement 11
Tissue Conductivity and Impedance Change 10
Electric Field Distribution and Modelling 7
Necrosis and Necroptosis 6
Optimisation of Pulse Parameters 6
Thermal Effect and Joule Heating 4
Electrode Geometry and Placement 4
Apoptosis Induction 4
Mitochondrial Dysfunction and Oxidative Stress 2
Study Type Distribution
Bar length is scaled to the most common study type; the percentage gives the share of the whole area. Colour marks the evidence tier of the study type, the same scale as the evidence map.
| Study type | Publications | Share within this area |
|---|---|---|
| Randomized Clinical Trial | 2 | 1% |
| Prospective Clinical Study | 4 | 3% |
| Clinical Study | 40 | 30% |
| Retrospective Clinical Study | 2 | 1% |
| Case Series | 6 | 4% |
| Case Report | 2 | 1% |
| Systematic Review / Meta-Analysis | 28 | 21% |
| Review | 11 | 8% |
| Animal Study | 25 | 19% |
| In Vitro Study | 1 | <1% |
| Preprint | 7 | 5% |
| Editorial / Letter | 3 | 2% |
| Correction / Erratum | 1 | <1% |
| Protocol | 2 | 1% |
| Not reported | 1 | <1% |
Literature Evidence Table
135 publications listed in order of evidence strength. Click a title to open the citation, mechanism and full abstract drawer.
| Regime | Publication | Year | Study type | Model | Mechanism | Abstract |
|---|---|---|---|---|---|---|
| Irreversible | Dashwood et al · Pacing Clin Electrophysiol | 2025 | Randomized Clinical Trial | Human | Irreversible Pore Formation and Cell Death | Introduction: Atrial fibrillation (AF) ablation often involves large-diameter catheters, posing challenges for post-procedure hemostasis and discharge. The impact of Perclose Prostyle vascul… |
| Irreversible | Younis et al · JACC Clin Electrophysiol | 2024 | Randomized Clinical Trial | Human | Irreversible Pore Formation and Cell Death, Tissue Conductivity and Impedance Change | Background: The efficacy of pulsed field ablation (PFA) for redo procedures is unknown. Objectives: In this study, the authors aimed to evaluate the effectiveness of PFA when performing PFA … |
| Irreversible | Keelani et al · JACC Clin Electrophysiol | 2026 | Prospective Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) may overcome key limitations of radiofrequency ablation (RFA) when treating premature ventricular contractions (PVCs) in anatomically complex regions … |
| Irreversible | Liu et al · J Interv Card Electrophysiol | 2026 | Prospective Clinical Study | Human | Irreversible Pore Formation and Cell Death | BACKGROUND: Pulsed field ablation (PFA) is an emerging innovative technology for treating paroxysmal atrial fibrillation (PAF), featured by its superior speed, accuracy, and reduced risk to … |
| Irreversible | Wong et al · JACC Clin Electrophysiol | 2026 | Prospective Clinical Study | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Pentaspline pulsed field ablation (PFA) is an emerging technology delivering ultra-short bursts of ablative high electrical field energy. There are limited studies on atrial fibr… |
| Irreversible | Eckart et al · Heart Rhythm O2 | 2025 | Prospective Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) has revolutionized catheter ablation procedures in terms of safety, efficiency, and efficacy. Streamlined zero-exchange workflows with therapy sheath … |
| Irreversible | Abeln et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Research on pulsed field ablation (PFA) systems for atrial fibrillation (AF) ablation has expanded rapidly in recent years, particularly with respect to short-term safety and effi… |
| Irreversible | Askarinejad et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Background Pulsed-field ablation (PFA) is an emerging non-thermal energy modality that induces irreversible electroporation, selectively affecting myocardial cells while sparing surrounding … |
| Irreversible | Bistriceanu et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Current atrial fibrillation (AF) guidelines and expert consensus documents from major societies discuss early arrhythmia recurrence (ER) within the first 3 months after catheter a… |
| Irreversible | Bobosik et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Muscle Contraction and Anaesthesia Requirement | Introduction In the Czech Republic, the majority of catheter ablation procedures for atrial fibrillation (AF) are currently performed using pulsed-field (PF) ablation. Management of older AF… |
| Irreversible | Ferro et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background Pulsed field ablation (PFA) has demonstrated comparable efficacy to radiofrequency ablation (RFA) in the treatment of atrial fibrillation (AF), with enhanced safety due to its car… |
| Irreversible | Hornof et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Muscle Contraction and Anaesthesia Requirement | Background There is limited data regarding the use of pulsed-field ablation (PFA) for mitral isthmus (MI) ablation in patients with non-paroxysmal atrial fibrillation (AF). Purpose To assess… |
| Irreversible | Huegl et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Transseptal puncture (TSP) for atrial fibrillation (AF) ablation in patients with septal occluder devices (SODs) is technically challenging because of altered septal anatomy and l… |
| Irreversible | Keelani et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Catheter ablation is the most effective therapy in patients with atrial tachycardia.1 Right atrial tachycardia may be challenging because of proximity to the phrenic nerve and sinus node, li… |
| Irreversible | Latini et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Aims Pulsed field ablation (PFA) has recently emerged as a promising alternative to conventional energy sources (ES) for atrial fibrillation (AF) ablation. However, comparative data between … |
| Irreversible | Makdah et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Pulsed field ablation (PFA) has emerged as a non-thermal ablation technology capable of producing myocardial lesions while minimizing collateral tissue injury. Although extensivel… |
| Irreversible | Makdah et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background/Introduction The superior vena cava (SVC) has been identified as a non-pulmonary vein trigger in atrial fibrillation (AF) and SVC isolation has been suggested for improvement of l… |
| Irreversible | Marino et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Experience on pulsed field ablation (PFA) in patients with a prior left atrial appendage (LAA) occlusion device is limited. Purpose This study aimed to assess the feasibility and … |
| Irreversible | Mills et al · J Cardiovasc Electrophysiol | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed-field ablation (PFA) has transformed atrial fibrillation (AF) ablation, but how the early patient experience compares with thermal techniques remains unclear. This study a… |
| Irreversible | Mitacchione et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Real-world evidence assessing the learning curve and procedural efficiency of the pentaspline pulsed-field ablation (PFA) system with novel mapping-integrated capabilities remains… |
| Irreversible | Miyama et al · J Cardiovasc Electrophysiol | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background: Little is known about the efficacy and safety of pulsed field ablation (PFA) for repeat ablation procedures for patients with recurrent atrial fibrillation (AF) after pulmonary v… |
| Irreversible | Pannone et al · Europace | 2026 | Clinical Study | Human | Reversible Membrane Permeabilisation, Optimisation of Pulse Parameters | Background Reversible electroporation (PFREV) has recently been described as a useful tool for mapping macroreentrant atrial tachycardias, allowing identification of the critical isthmus bef… |
| Irreversible | Roth et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Early rhythm control enhances cardiovascular outcomes in patients with atrial fibrillation (AF) and significant comorbidities. However, most evidence stems from antiarrhythmic dru… |
| Irreversible | Schiavone et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Aims Data on pulsed-field ablation (PFA) for atrial fibrillation (AF) in patients with heart failure (HF) are limited. To evaluate clinical outcomes of PFA in patients with AF and HF, strati… |
| Irreversible | Szeplaki et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Introduction Pulsed field ablation (PFA) has emerged as a leading catheter ablation modality for the treatment of atrial fibrillation (AF), producing durable lesions in the myocardium. Long-… |
| Irreversible | Tokutake et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Pulsed field ablation (PFA) selectively targets myocardial tissue while minimizing injury to surrounding structures. Although its safety and efficacy for pulmonary vein (PV) isola… |
| Irreversible | Valappil et al · Heart Rhythm | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Thermal Effect and Joule Heating | Background: Pulsed field ablation (PFA) induces cell death predominantly through irreversible electroporation (IRE), a non-thermal mechanism. However, Joule heating during PFA delivery may r… |
| Irreversible | Zarebski et al · Europace | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Cavotricuspid isthmus (CTI) ablation is the cornerstone of catheter ablation for typical atrial flutter (AFL). Pulsed field ablation (PFA) has emerged as an alternative therapy fo… |
| Irreversible | van der Graaf et al · J Cardiovasc Electrophysiol | 2026 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background: While various pulsed field ablation (PFA) systems for atrial fibrillation (AF) ablation have become available in recent years, data comparing long-term efficacy outcomes remain l… |
| Irreversible | Badertscher et al · Europace | 2025 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Radiofrequency and cryoablation have been the standard energy sources for pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF), whereas pulsed-field ablation (PFA) has em… |
| Irreversible | Duytschaever et al · JACC Clin Electrophysiol | 2025 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Omny-IRE (A Study For Treatment of Paroxysmal Atrial Fibrillation [PAF] With the OMNYPULSE Catheter and the TRUPULSE Generator) evaluated safety and effectiveness of a novel larg… |
| Irreversible | Rodriguez-Riascos et al · Circ Arrhythm Electrophysiol | 2025 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background: Cavotricuspid isthmus (CTI) ablation is frequently performed either as a standalone procedure or in combination with pulmonary vein isolation. With the rapid adoption of pulsed f… |
| Irreversible | Rossillo et al · Europace | 2025 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background Increased left atrial (LA) size in atrial fibrillation (AF) is associated with AF recurrence following ablation. Limited data exist on pulsed-field ablation (PFA) in patients with… |
| Irreversible | Woermann et al · Europace | 2025 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Tissue Conductivity and Impedance Change | Background Pulsed-field ablation (PFA) is a novel non-thermal atrial fibrillation (AF) ablation technique presumed safety benefits due to its tissue selectivity. However, the high-voltage el… |
| Irreversible | Reddy et al · Europace | 2024 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Aims Pulsed field ablation (PFA) has significant advantages over conventional thermal ablation of atrial fibrillation (AF). This first-in-human, single-arm trial to treat paroxysmal AF (PAF)… |
| Irreversible | Schiavone et al · J Cardiovasc Electrophysiol | 2024 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Introduction: Limited data exist on pulsed-field ablation (PFA) in patients with persistent atrial fibrillation (PeAF) undergoing left atrial posterior wall isolation (LAPWI). Methods: The A… |
| Irreversible | Turagam et al · Heart Rhythm | 2024 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background: During pulsed field ablation (PFA), electrode-tissue proximity optimizes lesion quality. A novel "single-shot" map-and-ablate spherical multielectrode PFA array catheter that is … |
| Irreversible | Anić et al · Europace | 2023 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Aims Pulsed field ablation (PFA) has emerged as a promising alternative to thermal ablation for treatment of atrial fibrillation (AF). We report performance and safety using the CENTAURI™ Sy… |
| Irreversible | Kirstein et al · J Cardiovasc Electrophysiol | 2023 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Thermal Effect and Joule Heating | Introduction: Atrio-esophageal fistula after esophageal thermal injury (ETI) is one of the most devastating complications of available energy sources for atrial fibrillation (AF) ablation. P… |
| Irreversible | Verma et al · Circulation | 2023 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Background: Pulsed field ablation uses electrical pulses to cause nonthermal irreversible electroporation and induce cardiac cell death. Pulsed field ablation may have effectiveness comparab… |
| Irreversible | Reinsch et al · Heart Rhythm | 2022 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) is a novel, nonthermal ablation modality that can ablate myocardial tissue with minimal effects on surrounding tissue. Preclinical data show an absenc… |
| Irreversible | Schmidt et al · Circ Arrhythm Electrophysiol | 2022 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Muscle Contraction and Anaesthesia Requirement | Background: Pulsed field ablation represents an energy source specific for ablation of cardiac arrhythmias including atrial fibrillation. The aim of the study was to describe the adoption an… |
| Irreversible | Cochet et al · Europace | 2021 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Aims Extra-atrial injury can cause complications after catheter ablation for atrial fibrillation (AF). Pulsed field ablation (PFA) has generated preclinical data suggesting that it selective… |
| Irreversible | Kawamura et al · Europace | 2021 | Clinical Study | Human | Irreversible Pore Formation and Cell Death | Aims We studied the extent/area of electrical pulmonary vein isolation (PVI) after either pulsed field ablation (PFA) using a pentaspline catheter or thermal ablation technologies. Methods a… |
| Irreversible | Nakatani et al · Europace | 2021 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Haemostasis and Bleeding Control | Aims Pulsed field ablation (PFA), a non-thermal ablative modality, may show different effects on the myocardial tissue compared to thermal ablation. Thus, this study aimed to compare the lef… |
| Irreversible | Reddy et al · J Am Coll Cardiol | 2019 | Clinical Study | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Catheter ablation of atrial fibrillation using thermal energies such as radiofrequency or cryothermy is associated with indiscriminate tissue destruction. During pulsed field abl… |
| Irreversible | Al-slaimieh et al · Front Cardiovasc Med | 2026 | Retrospective Clinical Study | Human | Irreversible Pore Formation and Cell Death | Introduction: Pulsed field ablation (PFA) is a novel, non-thermal method for the treatment of atrial fibrillation (AF). We conducted this study, as part of one of the earliest reports origin… |
| Irreversible | Turagam et al · Circulation | 2023 | Retrospective Clinical Study | Human | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Background: Pulsed field ablation is a novel nonthermal cardiac ablation modality using ultra-rapid electrical pulses to cause cell death by a mechanism of irreversible electroporation. Unli… |
| Irreversible | Ballesteros et al · J Interv Card Electrophysiol | 2026 | Case Series | Human | Irreversible Pore Formation and Cell Death, Muscle Contraction and Anaesthesia Requirement | Background: The PulseSelect™ circular pulsed field ablation (PFA) catheter demonstrated excellent safety in its pivotal trial, but real-world evidence on its early adoption and implementatio… |
| Irreversible | Follesa et al · J Arrhythm | 2026 | Case Series | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed-field ablation (PFA) is increasingly used for catheter ablation of atrial fibrillation (AF), but older patients remain underrepresented in clinical trials. This study aime… |
| Irreversible | Ha et al · J Arrhythm | 2026 | Case Series | Human | Irreversible Pore Formation and Cell Death | Background: Older patients have been under-represented in clinical trials of atrial fibrillation (AF) ablation. The safety of pulsed field ablation (PFA) in this cohort is not known. Methods… |
| Irreversible | Sawada et al · Heart Rhythm O2 | 2026 | Case Series | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) is a novel therapy for atrial fibrillation (AF) with myocardial selectivity and safety. The VARIPULSE catheter (variable-loop circular catheter [VLCC]… |
| Irreversible | Tilz et al · J Interv Card Electrophysiol | 2026 | Case Series | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: The balloon-in-basket(BiB) pulsed field ablation(PFA) system integrates real-time electroanatomic mapping and contact sensing to streamline workflows, but clinical experience rem… |
| Irreversible | Wójcik et al · J Interv Card Electrophysiol | 2026 | Case Series | Human | Irreversible Pore Formation and Cell Death | Purpose: Pulsed-field ablation (PFA) is established for pulmonary vein isolation, but data on superior vena cava (SVC) isolation are limited. We assessed the feasibility and acute safety of … |
| Irreversible | Jadczyk et al · Eur Heart J Case Rep | 2026 | Case Report | Human | Irreversible Pore Formation and Cell Death | Background Pulmonary vein stenosis (PVS) is an uncommon but serious complication of atrial fibrillation (AF) ablation. Angioplasty with stent implantation is the standard treatment for sever… |
| Irreversible | Onuki et al · Pacing Clin Electrophysiol | 2026 | Case Report | Human | Irreversible Pore Formation and Cell Death | Pulsed-field ablation (PFA) in patients with an implanted extravascular implantable cardioverter-defibrillator (EV-ICD) poses theoretical risks of electromagnetic interference or lead displa… |
| Irreversible | Ahmed et al · J Interv Card Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | BACKGROUND: Cryoballoon ablation (CBA) is a widely used method for pulmonary vein isolation (PVI), while Pulsed-Field ablation (PFA) is a newer, non-thermal technique that shows promise for … |
| Irreversible | Al Diab Al Azzawi et al · BMC Cardiovasc Disord | 2026 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | BACKGROUND: Pulsed field ablation (PFA) is a non-thermal alternative to cryoballoon ablation (CBA) for pulmonary vein isolation in atrial fibrillation (AF). We compared their procedural effi… |
| Irreversible | Alnomani et al · J Arrhythm | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: With over 60 million cases worldwide, atrial fibrillation (AF) is one of the most common cardiac arrhythmias in adults. Pulsed-field ablation (PFA) has emerged as a significant a… |
| Irreversible | Arevalo et al · J Cardiovasc Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death | Introduction: The conventional 3-month blanking period after atrial fibrillation (AF) ablation has been applied irrespective of energy modality. Pulsed field ablation (PFA), a nonthermal tec… |
| Irreversible | Bax et al · Heart Rhythm | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death | Pulsed field ablation (PFA) is emerging as an alternative to thermal ablation for pulmonary vein isolation (PVI) in atrial fibrillation, although PFA-specific complications have arisen. This… |
| Irreversible | Bokhari et al · Medicine (Baltimore) | 2026 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Atrial fibrillation (AF) remains the most common sustained cardiac arrhythmia. Pulsed field ablation (PFA) and cryoablation (CA) aim to isolate pulmonary veins and prevent AF rec… |
| Irreversible | Bregion et al · J Cardiovasc Dev Dis | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) has shown promising results for atrial fibrillation (AF), with efficacy comparable to established ablation techniques. High-power short-duration (HPSD… |
| Irreversible | Cao et al · Front Cardiovasc Med | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) and very high power short duration ablation (vHPSD) are new techniques for catheter ablation of atrial fibrillation that have been rapidly developed i… |
| Irreversible | Erzinger et al · J Interv Card Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death | BACKGROUND: The efficacy and safety of pulsed-field (PFA) ablation with zero/low-fluoroscopy (ZF/LF) approach is unclear with previous evidence limited to thermal technique. METHODS: PubMed,… |
| Irreversible | Ha et al · J Interv Card Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death | BACKGROUND: Limited real-world data exist regarding pulmonary vein (PV) and posterior wall (PW) durability after index pulsed field ablation (PFA) for atrial fibrillation (AF) in patients un… |
| Irreversible | Li et al · Pacing Clin Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) is an emerging nonthermal ablation modality that can penetrate scar tissue more deeply. However, the evidence supporting its application in ventricula… |
| Irreversible | Li et al · BMC Cardiovasc Disord | 2026 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) has emerged as an innovative non-thermal approach with significant promise for treating atrial fibrillation (AF). However, comparative data between PF… |
| Irreversible | Mehta et al · J Interv Card Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death | Background: Cavotricuspid isthmus (CTI) dependent atrial flutter (AFL) is conventionally managed using radiofrequency catheter ablation. Pulsed field ablation (PFA) is an emerging non-therma… |
| Irreversible | Mojica et al · BMC Cardiovasc Disord | 2026 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death | BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia and a leading cause of stroke. Pulsed field ablation (PFA) emerges as a novel, non-thermal energy source offering m… |
| Irreversible | Oudih et al · Pacing Clin Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Introduction: Pulsed-field ablation (PFA) is a novel, nonthermal modality for the treatment of atrial fibrillation (AF) that may reduce procedural complications compared with conventional th… |
| Irreversible | Pajareya et al · Pacing Clin Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Pulse field ablation (PFA) is an emerging catheter ablation strategy for patients with atrial fibrillation (AF). Nonetheless, the safety and efficacy of PFA in elderly patients r… |
| Irreversible | Sawalha et al · Pacing Clin Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death | Background: Fluoroscopy reduction has become a priority in electrophysiology to mitigate radiation exposure and the musculoskeletal burden of lead apron use. Pulsed field ablation (PFA) offe… |
| Irreversible | Villarreal et al · J Cardiovasc Electrophysiol | 2026 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death | Background and aims: Pulsed field ablation (PFA) has emerged as a non-thermal alternative for pulmonary vein isolation (PVI), offering shorter procedural times and a favorable safety profile… |
| Irreversible | Wan et al · Sci Rep | 2026 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death | Pulsed field ablation (PFA)-guided pulmonary vein isolation (PVI) has limited efficacy in treating persistent atrial fibrillation (AF) and requires additional substrate modification, but the… |
| Irreversible | Abbas et al · – | 2025 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Pulsed field ablation (PFA) is an established modality for atrial fibrillation (AF) due to myocardial selectivity and reduced collateral injury. Its role in ventricular tachycard… |
| Irreversible | Arrighini et al · J Interv Card Electrophysiol | 2025 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) is a novel, non-thermal technique for atrial fibrillation ablation that is currently under early investigation for paroxysmal supraventricular tachyca… |
| Irreversible | Barbosa et al · J Interv Card Electrophysiol | 2025 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed-field ablation (PFA) has emerged as a potentially safer alternative to radiofrequency ablation (RFA). However, recent studies have raised concerns that PFA may induce hemo… |
| Irreversible | Marazzato et al · Prog Cardiovasc Dis | 2025 | Systematic Review / Meta-Analysis | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Pulsed field ablation (PFA) is a novel and minimally thermal energy source that exploits the biophysics of irreversible electroporation (IRE) to cause cell death. Differently from radiofrequ… |
| Irreversible | Mohamed et al · J Arrhythm | 2025 | Systematic Review / Meta-Analysis | Literature Analysis | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Pulmonary vein isolation is a standard therapy for paroxysmal atrial fibrillation (AF). Pulsed field ablation (PFA) has emerged as a novel approach aiming to improve efficacy and… |
| Irreversible | Prajapati et al · Pacing Clin Electrophysiol | 2025 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death | Background: While radiofrequency ablation (RFA) and cryoablation (CBA) are established treatments for atrial fibrillation (AF), pulsed field ablation (PFA) offers potential benefits. This st… |
| Irreversible | Aldaas et al · J Interv Card Electrophysiol | 2023 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death | Background: Pulsed field ablation (PFA) induces cell death through electroporation using ultrarapid electrical pulses. We sought to compare the procedural efficiency characteristics, safety,… |
| Irreversible | O'Neill et al · J Surg Oncol | 2020 | Systematic Review / Meta-Analysis | Human | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Background and objectives: Irreversible electroporation (IRE) is a nonthermal electrical tumor ablative strategy for unresectable tumors. IRE is relatively safe around critical structures bu… |
| Irreversible | Sugrue et al · J Interv Card Electrophysiol | 2019 | Systematic Review / Meta-Analysis | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Introduction: Irreversible electroporation (IRE) utilizing high voltage pulses is an emerging strategy for catheter-based cardiac ablation with considerable growth in the preclinical arena. … |
| Irreversible | Pürerfellner · Europace | 2026 | Review | Human | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Pulsed field ablation (PFA) has rapidly evolved from an experimental electroporation-based concept to a widely adopted modality in cardiac electrophysiology, marking one of the fastest clini… |
| Irreversible | Eberl et al · J Cardiovasc Dev Dis | 2025 | Review | Literature Analysis | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Understanding the biophysics of electroporation-the mechanism by which pulsed electric fields achieve tissue ablation-is essential for advancing this emerging technology. In this review, we … |
| Irreversible | Jacobs · Radiol Oncol | 2025 | Review | Human | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Background: Focal ablation techniques are integral in the surgical intervention of diseased tissue, where it is necessary to minimize damage to the surrounding parenchyma and critical struct… |
| Irreversible | Levy et al · Pacing Clin Electrophysiol | 2025 | Review | Human | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Pulsed field ablation (PFA) is a cutting-edge treatment for arrhythmias that targets cardiac tissue with rapid, high-voltage electric current pulses, resulting in irreversible electroporatio… |
| Irreversible | Neven · Arrhythm Electrophysiol Rev | 2025 | Review | Literature Analysis | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | 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 electr… |
| Irreversible | Ezzeddine et al · J Clin Med | 2024 | Review | Literature Analysis | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | One of the recent advancements in the field of cardiac electrophysiology is pulsed field ablation (PFA). PFA is a novel energy modality that does not rely on thermal processes to achieve abl… |
| Irreversible | Guttipatti et al · Heart Surg Forum | 2024 | Review | Literature Analysis | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Pulsed field ablation (PFA) is a novel technology to treat atrial fibrillation (AF) utilizing electric fields to induce nonthermal irreversible electroporation of electrically active cardiac… |
| Irreversible | Di Monaco et al · J Cardiovasc Dev Dis | 2022 | Review | Literature Analysis | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and catheter ablation, which can be used in symptomatic patients refractory to antiarrhythmic therapy. Pulmonary vein… |
| Irreversible | Maan et al · Curr Cardiol Rep | 2022 | Review | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Purpose of review: Current ablation approach for arrhythmias relies upon the use of radiofrequency (RF) and cryoablation catheters. Although there have been significant advances both in cath… |
| Irreversible | Bradley et al · J Cardiovasc Electrophysiol | 2020 | Review | Human | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Pulsed-field ablation (PFA) is a promising new ablation modality for the treatment of atrial fibrillation. This energy form employs a train of microsecond duration high amplitude electrical … |
| Irreversible | Sugrue et al · Expert Rev Cardiovasc Ther | 2018 | Review | Animal (In Vivo) | Reversible Membrane Permeabilisation, Irreversible Pore Formation and Cell Death | Cardiac ablation is an established treatment modality for the management of patients with cardiac arrhythmias. Current approaches to cardiac ablation employ thermal based energy to achieve l… |
| Irreversible | Salameh et al · Ann Biomed Eng | 2026 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Tissue Conductivity and Impedance Change | Purpose: Atherosclerotic vascular disease remains a leading cause of morbidity and mortality worldwide. Current treatments such as angioplasty, stenting, and atherectomy are invasive and lim… |
| Irreversible | Sowa et al · Bioelectrochemistry | 2026 | Animal Study | Animal (In Vivo) | Reversible Membrane Permeabilisation, Nanosecond Pulsed Electric Field (nsPEF) | Achieving complete cardiac ablation requires higher electric fields, increasing the risk of vasospasm or collateral injury. A potential strategy to enhance ablation efficacy without raising … |
| Irreversible | Jacobs · Ann Biomed Eng | 2025 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Tissue Conductivity and Impedance Change | Purpose: High-frequency irreversible electroporation (H-FIRE) is a pulsed field ablation (PFA) technique that employs a series of high-voltage, microseconds-long positive and negative pulses… |
| Irreversible | Ye et al · J Cardiovasc Electrophysiol | 2025 | Animal Study | Animal (In Vivo) | Electric Field Distribution and Modelling, Reversible Membrane Permeabilisation | Background: Cardiomyocyte lines are widely used in cardiovascular research. For cardiac ablation, the factors affecting cardiomyocytes by pulsed electrical field (PEF) ablation are being inv… |
| Irreversible | Bhardwaj et al · Heart Rhythm | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Muscle Contraction and Anaesthesia Requirement | Focal delivery of microsecond pulsed field ablation (PFA) using small and large round/cylindrical tips have been described. Objective: To evaluate nanosecond (ns)PFA delivery using a novel f… |
| Irreversible | Di Biase et al · Circ Arrhythm Electrophysiol | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death | Background: The effect of contact force (CF) on lesion formation is not clear during pulsed field ablation (PFA). The aim of this study was to evaluate the impact of CF, PFA, and their inter… |
| Irreversible | Hua et al · Clin Cardiol | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Pulsed field ablation (PFA) has emerged as a novel non-thermal modality with highly myocardium-specific. However, the PFA catheter based on contact force (CF)-sensing has not bee… |
| Irreversible | Kocharian et al · Heart Rhythm | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death | Despite the good safety profile of pulsed-filed energy (PF) for the ablation of atrial fibrillation (AF) reported in clinical studies, cases of renal failure caused probably by hemolysis wer… |
| Irreversible | Koruth et al · Heart Rhythm | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death | Pericardial adhesions develop in patients’ hearts after surgical cardiac intervention or infection. These adhesions make epicardial interventions such as ablation laborious. Advancing surgic… |
| Irreversible | Koya et al · J Cardiovasc Electrophysiol | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Calcium Electroporation and ATP Depletion | Introduction: Pulsed field ablation (PFA) has emerged as an innovative therapy for cardiac arrhythmias. Drawing parallels with PFA's application in solid tumors, calcium chloride (CaCl 2 ) a… |
| Irreversible | Nakagawa et al · Circ Arrhythm Electrophysiol | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Necrosis and Necroptosis | Background: During pulsed field ablation (PFA), relationships between ablation parameters (contact force [CF], number of burst pulses, impedance decrease, and electrode temperature) and lesi… |
| Irreversible | Nies et al · Circ Arrhythm Electrophysiol | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Muscle Contraction and Anaesthesia Requirement | Background: Endocardial catheter-based pulsed field ablation (PFA) of the ventricular myocardium is promising. However, little is known about PFA's ability to target intracavitary structures… |
| Irreversible | Younis et al · JACC Clin Electrophysiol | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Tissue Conductivity and Impedance Change | Background: Comparative efficacy and safety data on radiofrequency ablation (RFA) versus pulsed field ablation (PFA) for common idiopathic left ventricular arrhythmia (LV-VAs) locations are … |
| Irreversible | Younis et al · Circ Arrhythm Electrophysiol | 2024 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Tissue Conductivity and Impedance Change | Background: Conventional focal radiofrequency catheters may be modified to enable multiple energy modalities (radiofrequency or pulsed field [PF]) with the benefit of contact force (CF) feed… |
| Irreversible | Di Biase et al · Circ Arrhythm Electrophysiol | 2023 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Pulsed field ablation (PFA) has emerged as an alternative to radiofrequency ablation. However, data on focal point-by-point PFA are scarce. The aim of this study was to compare l… |
| Irreversible | Gasperetti et al · Europace | 2023 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Aims Pulsed field ablation (PFA) is a non-thermal ablative approach in which cardiomyocyte death is obtained through irreversible electroporation (IRE). Data correlating the biophysical char… |
| Irreversible | Mattison et al · J Cardiovasc Electrophysiol | 2023 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death | Introduction: Contact force has been used to titrate lesion formation for radiofrequency ablation. Pulsed field ablation (PFA) is a field-based ablation technology for which limited evidence… |
| Irreversible | Howard et al · Circ Arrhythm Electrophysiol | 2022 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Electric Field Distribution and Modelling | Background: Pulsed field ablation (PFA) is a novel energy modality for treatment of cardiac arrhythmias. The impact of electrode-tissue proximity on lesion formation by PFA has not been conc… |
| Irreversible | Li et al · BMC Cardiovasc Disord | 2021 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Background: High-Frequency Irreversible Electroporation (H-FIRE) is a novel technology for non-thermal ablation. Different from Irreversible electroporation (IRE), H-FIRE delivers bipolar el… |
| Irreversible | Koruth et al · Circ Arrhythm Electrophysiol | 2020 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background: Pulsed field ablation (PFA) can be myocardium selective, potentially sparing the esophagus during left atrial ablation. In an in vivo porcine esophageal injury model, we compared… |
| Irreversible | Stewart et al · Heart Rhythm | 2019 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Electrode Geometry and Placement | Background: Radiofrequency (RF) has become an accepted energy source for myocardial ablation but may result in discontinuous lesions and nontargeted tissue injury. We examined the feasibilit… |
| Irreversible | van Es et al · Biomed Eng Online | 2019 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Background: Irreversible electroporation (IRE) using direct current (DC) is an effective method for the ablation of cardiac tissue. A major drawback of the use of DC-IRE, however, are two pr… |
| Irreversible | Jiang et al · Journal of Medical Devices | 2013 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Optimisation of Pulse Parameters | Cardiovascular disease remains the number one cause of death in the United States, and in 2010 was responsible for 17% of the US health expenditures ($272.5 billion) [1]. Many acquired cardi… |
| Irreversible | Deodhar et al · AJR Am J Roentgenol | 2011 | Animal Study | Animal (In Vivo) | Reversible Membrane Permeabilisation, Irreversible Pore Formation and Cell Death | Objective: Irreversible electroporation is a nonthermal ablative tool that uses direct electrical pulses to create irreversible membrane pores and cell death. The ablation zone is surrounded… |
| Irreversible | Lavee et al · Heart Surg Forum | 2007 | Animal Study | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Background: All currently used energy sources in surgical ablation for atrial fibrillation create lesions via thermal injury. We report for the first time the in vivo results of a new nonthe… |
| Irreversible | Zarębski et al · J Interv Card Electrophysiol | 2026 | In Vitro Study | Cell Culture | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Introduction: Pulsed field ablation (PFA) is a novel technique for pulmonary vein isolation (PVI) in the treatment of atrial fibrillation (AF). However, the impact of electrode type on lesio… |
| Irreversible | Herranz et al · – | 2026 | Preprint | – | Irreversible Pore Formation and Cell Death, Apoptosis Induction | Pulsed field ablation (PFA) is increasingly used for atrial fibrillation, but the mechanisms of PFA-induced cell death remain incompletely understood. This study aimed to elucidate the early… |
| Irreversible | Jacobs et al · – | 2026 | Preprint | Animal (In Vivo) | Tissue Conductivity and Impedance Change, Irreversible Pore Formation and Cell Death | Objective Pulsed field ablation (PFA) relies on irreversible electroporation to create nonthermal cardiac lesions, yet real-time indicators of electroporation progression and validated letha… |
| Irreversible | Li et al · – | 2026 | Preprint | – | Irreversible Pore Formation and Cell Death, Muscle Contraction and Anaesthesia Requirement | Background Patients undergoing pulsed field ablation (PFA) for atrial fibrillation (AF) often have comorbid cardiovascular diseases and are highly sensitive to circulatory depression during … |
| Irreversible | Ullah et al · – | 2026 | Preprint | – | Irreversible Pore Formation and Cell Death, Preservation of Nerve and Vascular Structures | Background Three pulsed-field ablation (PFA) systems are FDA-approved for atrial fibrillation (AF), yet whether their safety profiles differ from each other and from radiofrequency (RF) abla… |
| Irreversible | Wan et al · – | 2026 | Preprint | – | Irreversible Pore Formation and Cell Death | Pulsed field ablation (PFA)-guided pulmonary vein isolation (PVI) has limited efficacy in treating persistent atrial fibrillation (AF) and requires additional substrate modification, but the… |
| Irreversible | Wang et al · – | 2026 | Preprint | – | Irreversible Pore Formation and Cell Death | Aims Pulsed field ablation (PFA) is a growing ablation modality for pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients. This study assesses the 6-month safety and effectiven… |
| Irreversible | Salameh et al · – | 2025 | Preprint | Animal (In Vivo) | Irreversible Pore Formation and Cell Death, Tissue Conductivity and Impedance Change | Background Atherosclerotic vascular disease remains a leading cause of morbidity and mortality worldwide. Current treatments such as angioplasty, stenting, and atherectomy are invasive and l… |
| Irreversible | Campos-Villarreal et al · JACC Case Rep | 2026 | Editorial / Letter | – | Irreversible Pore Formation and Cell Death | [Figure: see text] |
| Irreversible | Nies et al · Circ Arrhythm Electrophysiol | 2024 | Editorial / Letter | Human | Irreversible Pore Formation and Cell Death | Circulation: Arrhythmia and Electrophysiology RESEARCH LETTER Hemolysis After Pulsed Field Ablation: Impact of Lesion Number and Catheter-Tissue Contact Moritz Nies , MD; Jacob S. Koruth , M… |
| Irreversible | Koruth et al · JACC Clin Electrophysiol | 2022 | Editorial / Letter | Human | Irreversible Pore Formation and Cell Death | cells from the mechanism of is esophageal contraction during atrial PFA, as well as ventricular contraction during annular or ventricular PFA. Catheter design, contact force, pulse waveform,… |
| Irreversible | Ha et al · J Interv Card Electrophysiol | 2026 | Correction / Erratum | – | Irreversible Pore Formation and Cell Death | r atrial fibrillation: tertiary centre experience and meta-analysis of observational studies Francis J. Ha1 · Sarah Paitry1 · Duron Prinsloo1 Emily Kotschet1 · Hui-Chen Han1 · Adam J Brown1 … |
| Irreversible | Krishan et al · Eur Heart J Open | 2025 | Not reported | – | Irreversible Pore Formation and Cell Death | Graphical Abstract. |
| Irreversible | Lin et al · J Cardiovasc Electrophysiol | 2025 | Protocol | Human | Irreversible Pore Formation and Cell Death, Reversible Membrane Permeabilisation | Background: Pulsed field ablation (PFA) is gaining recognition as a nonthermal, tissue-specific technique for the treatment of atrial fibrillation (AF). The preclinical evaluation of the inv… |
| Irreversible | Reddy et al · Heart Rhythm O2 | 2023 | Protocol | – | Irreversible Pore Formation and Cell Death | Background: Pulmonary vein isolation (PVI) is an effective treatment for paroxysmal atrial fibrillation (PAF). However, potential complications can occur due to the propagation of thermal en… |
Limitations
The counts on this page are bounded by the scope of the source PDF archive and are not a systematic review of the area's literature. Study type and mechanism labels are derived automatically; for critical decisions consult the full texts of the publications listed. The evidence level reflects the number of publications, not their methodological quality.