Catheter ablation is a relatively effective method for maintaining sinus rhythm in patients with atrial fibrillation (AF). Pulsed field ablation (PFA) as a novel form of ablation energy exhibits tissue selectivity. Its efficacy in treating paroxysmal AF has been clinically demonstrated. However, the ablation of persistent AF is more complex and risky. Currently, the use of PFA for persistent AF is also gradually gaining traction. This article provides a review of the latest research progress on the efficacy, complications and its ablation strategies in the treatment of persistent AF.

Pulsed field ablation (PFA) is a promising novel technique for arryhthmia ablation. It increases cell membrane permeability by irreversible electroporation mechanism, destructs intracellular homeostasis, and causes cell death. Meanwhile, due to its characteristics including high tissue specificity and nonthermal ablation, the application of PFA has been more and more attractive in the treatment of arrhythmias. This article reviews the mechanism, characteristics and progress on the clinical application of PFA in arrhythmias.

Pulsed field ablation (PFA) as an emerging ablation technology with characteristics of nonthermal mechanism and tissue selectivity could effectively reduce the damage to adjacent organs, and tissues (such as the esophagus, coronary arteries and phrenic nerve) caused by ablation. This article aims to discuss the application of PFA in atrial and ventricular arrhythmias, with a focus on its safety and effectiveness, and looks forward to its further application potential.

心房颤动（简称房颤）是临床最常见的心律失常之一，严重影响患者的生活质量，并显著增加死亡、脑卒中、心力衰竭和痴呆的风险。射频消融已经成为最主要的房颤节律控制方法，但其疗效有个体差异性，且存在一定的严重并发症发生率、学习曲线长等不足。脉冲电场消融作为一种新型的房颤消融方式，通过短时程、高电压的电脉冲释放消融能量，以不可逆电穿孔机制消融心脏组织，具有组织特异性及安全性高、学习曲线短等优点。近日，哈特瑞姆心血管病医院采用Pentaspline多极脉冲电场消融导管，成功治疗了1例持续性房颤合并心包积液患者。术后1个月，患者心功能和生活质量均得到了显著改善。

This article delineates the procedures of petal-shaped pulsed field ablation (PFA) catheter, which include the puncture of the interatrial septum, insertion of the PFA catheter, implementation of the “231” ablation strategy, and verification of pulmonary vein isolation. Additionally, it explores operational techniques to increase the success rate of pulmonary vein isolation, such as the adjustment of the catheter's rotation angle, supplementary ablation between adjacent pulmonary veins, management of common pulmonary vein trunks, and ablation manipulation of the right inferior pulmonary vein and the superior vena cava. By standardized procedural steps and techniques, petal-shaped PFA catheter significantly improves the success rate of ablation and reduces complications, offering a novel and effective approach to the treatment of atrial fibrillation.

Pulsed electric field is an emerging energy source for cardiac catheter ablation. It creates pores in the cell membrane through high-voltage pulsed electric field, leading to cell apoptosis or necrosis. Pulsed field ablation (PFA) offers several advantages, including relatively selective myocardial injury, rapid lesion formation, and temperature-independent lesion creation. It has been widely applied in catheter ablation therapy for atrial fibrillation. Currently, cutting-edge research on PFA is advancing into the field of ventricular arrhythmias. This article reviews the latest developments in PFA for the treatment of ventricular arrhythmias based on recent research findings.