Pulse Field Ablation: From Bench to Blueprint: Mechanistic Insights and Device Engineering and Early Clinical Translation.

Abstract

Pulsed field ablation has rapidly reshaped the landscape of atrial fibrillation ablation by offering a nonthermal, tissue-selective alternative to conventional thermal energy. This review highlights the scientific foundations, preclinical evidence, and engineering advances that established pulsed field ablation as a safer, faster, and more precise technology. We discuss how irreversible electroporation achieves myocardial selectivity, the pivotal studies that confirmed preservation of nearby structures, and the evolution of modern catheter systems designed for efficient and durable lesion creation. As pulsed field ablation platforms continue to mature, they are redefining procedural safety standards and expanding therapeutic possibilities in cardiac electrophysiology.