Continued Opportunities for Innovation in the Era of PFA Powered by Kardium-Continued Opportunities for Innovation in the Era of PFA Powered by Kardium

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Video Summary

In this Innovation Partner Roundtable, five electrophysiologists discussed the impact and future of Pulse Field Ablation (PFA) in atrial fibrillation treatment. They agreed PFA has revolutionized workflows by enhancing safety and procedural efficiency compared to traditional RF ablation, though some cautioned about durability and efficacy still needing improvement. Mapping remains essential, particularly in persistent or redo cases, to tailor substrate modification beyond pulmonary vein isolation and address individual patient variability. Contact sensing during ablation is valued for ensuring lesion quality and durability, with emerging technologies providing different methods such as force, impedance, or proximity measurement.<br /><br />Catheter design innovation, including large footprint versus smaller or point-by-point catheters, was debated, emphasizing the balance between ease of use, versatility, and cost-effectiveness. Directed energy delivery was seen as promising for minimizing collateral tissue injury and hemolysis. The panel stressed the need for integrated systems combining mapping, ablation, and contact assessment to optimize outcomes.<br /><br />Looking ahead, excitement surrounded next-generation PFA technologies that enable precise lesion placement, linear or complex atrial ablation, and advanced substrate mapping possibly aided by AI. Improvements in identifying arrhythmia drivers and personalizing therapy were deemed critical. Additionally, upstream therapies targeting autonomic modulation may complement ablation advances. Overall, the panel envisions more efficient, reproducible, and patient-specific AF treatments evolving with PFA innovations.

Keywords

Pulse Field Ablation

atrial fibrillation treatment

electrophysiology

mapping in ablation

contact sensing

catheter design

directed energy delivery

next-generation PFA technologies