{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:10:47Z","timestamp":1792642247666,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pulsed field ablation (PFA) represents one of the most significant technological advances in atrial fibrillation (AF) therapy in recent decades. By harnessing irreversible electroporation, PFA produces myocardial lesions within milliseconds, enabling rapid and efficient pulmonary vein (PV) isolation. Early clinical experience from pivotal investigational device exemption (IDE) trials has shown acute and one-year arrhythmia-free outcomes that are non-inferior to conventional radiofrequency (RF) and cryothermal ablation. The large MANIFEST-17\u2005K registry, encompassing over 17 000 patients treated with the Farawave system, reported an exceptionally low 0.98% major complication rate with no atrio-oesophageal fistula, phrenic nerve injury, or PV stenosis. These findings have accelerated PFA adoption across many centres. However, as experience broadens, nuances in lesion formation and durability are becoming evident. Factors such as contact force, catheter rotation, pulse train configuration, and target tissue geometry influence lesion depth and transmurality. While PV isolation appears consistently durable, data remain limited for non-PV targets such as the posterior wall, mitral isthmus, and cavotricuspid isthmus. Moreover, novel PFA-specific complications including transient left atrial dysfunction, haemolysis, and coronary artery spasm warrant ongoing vigilance. PFA has undoubtedly transformed expectations for procedural safety and efficiency. Yet whether it should already be considered the standard technique for all AF ablation candidates remains an open question. This Controversy piece explores the balance between innovation and evidence, examining whether PFA\u2019s rapid rise represents the inevitable new standard or a technology still undergoing critical refinement.<\/jats:p>","DOI":"10.1093\/europace\/euaf326","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T12:36:06Z","timestamp":1766406966000},"source":"Crossref","is-referenced-by-count":29,"title":["Controversy: pulsed field ablation is the standard technique for all the candidates for atrial fibrillation ablation"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6508-4047","authenticated-orcid":false,"given":"Luigi","family":"Di Biase","sequence":"first","affiliation":[{"name":"Montefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center , 111 E 210th street, Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6355-8843","authenticated-orcid":false,"given":"Fengwei","family":"Zou","sequence":"additional","affiliation":[{"name":"Montefiore Einstein Center for Heart and Vascular Care, Montefiore Medical Center , 111 E 210th street, Bronx, NY 10467 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0537-9262","authenticated-orcid":false,"given":"Wa\u00ebl","family":"Zaher","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Heart Rhythm Research Brussels, Postgraduate Program in Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel , Brussels ,","place":["Belgium"]},{"name":"Heart Rhythm Management Department, Clinique Pasteur , 45 Avenue de Lombez, Toulouse 31076 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6857-7418","authenticated-orcid":false,"given":"Jalaj","family":"Garg","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health , Loma Linda, CA 92354 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-7042","authenticated-orcid":false,"given":"Serge","family":"Boveda","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Heart Rhythm Research Brussels, Postgraduate Program in Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel , Brussels ,","place":["Belgium"]},{"name":"Heart Rhythm Management Department, Clinique Pasteur , 45 Avenue de Lombez, Toulouse 31076 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1492-2693","authenticated-orcid":false,"given":"Dhanunjaya","family":"Lakkireddy","sequence":"additional","affiliation":[{"name":"Kansas City Heart Rhythm Institute, University of Missouri-Columbia, HCA Midwest Health , 10500, West 105th Street, Suite 200, Overland Park, KS 661215 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,24]]},"container-title":["Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/advance-article-pdf\/doi\/10.1093\/europace\/euaf326\/66120997\/euaf326.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/advance-article-pdf\/doi\/10.1093\/europace\/euaf326\/66120997\/euaf326.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/advance-article-pdf\/doi\/10.1093\/europace\/euaf326\/66120997\/euaf326.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:11:53Z","timestamp":1767175913000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/doi\/10.1093\/europace\/euaf326\/8403716"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":0,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euaf326","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,12,1]]},"article-number":"euaf326"}}