Pulsed field ablation (PFA)

Pulsed field ablation (PFA) is a **nonthermal tissue ablation technique** that employs high-amplitude, short-duration pulsed electric fields to selectively destroy targeted cells and tissues via irreversible electroporation[1][3][6]. Unlike thermal methods (radiofrequency, cryoablation), PFA directly affects cell membranes, creating irreversible nanopores that disrupt cellular homeostasis, leading to cell death, while largely sparing the extracellular matrix and nearby non-target tissues[1][2][5]. PFA has gained prominence in cardiac electrophysiology for ablation of atrial fibrillation due to its rapid, efficient, and relatively safe tissue-selective effects[1][3][6]. It is also investigated for tumor ablation and tissue engineering, with growing evidence for its potential in scarless tissue regeneration[5][6]. PFA is not a drug target; it is a procedural technology whose effects depend on physical parameters rather than molecular interactions.

Other names

Pulsed electric field ablationIrreversible electroporation (when used for ablation)Nonthermal ablation via pulsed electric fieldsPEF ablationElectroporation ablation

High-voltage, rapidly pulsed electric fields create nanopores in cell membranes (electroporation) If the electric field is sufficiently strong, pores become irreversible, leading to loss of membrane integrity, apoptosis or necrosis Preferential ablation of certain cell types (e.g. cardiomyocytes) due to differential electroporation thresholds