Abstract:

Pulsed field ablation (PFA) represents a transformative non-thermal therapeutic approach in interventional electrophysiology, characterized by its mechanism of inducing irreversible electroporation (IRE) through the delivery of high-intensity, ultrashort electric field pulses to achieve precise myocardial tissue ablation. The safety and feasibility of this technology have been thoroughly validated in the treatment of adult atrial arrhythmias, particularly atrial fibrillation. However, clinical research and application in the pediatric field have significantly lagged behind. Key barriers to its pediatric application include a pronounced scarcity of dedicated clinical evidence, the unavailability of catheter technologies tailored to the anatomical peculiarities of the developing heart, and unique procedural and safety challenges associated with the dynamic and often congenitally abnormal cardiac anatomy in children. This review summarizes the mechanistic foundations and current clinical landscape of PFA, with an emphasis on analyzing the central challenges and potential strategic solutions for its implementation in pediatric arrhythmia management. Meanwhile, this short review is to facilitate a deeper understanding of this emerging technology among pediatric clinicians, and to accelerate its standardized and evidence-based integration into pediatric practice.

Key words: pulsed field ablation, arrhythmia, child