Emerging Energy Sources for Catheter Ablation of Atrial Fibrillation

Abstract

Catheter‐based ablation techniques have been increasingly used as a curative therapy for treating atrial fibrillation (AF). Currently, radiofrequency (RF) energy is the most widely accepted and used method for catheter ablation of AF. However, RF ablation has potential disadvantages, including endocardial disruption, charring, platelet activation, pulmonary vein stenosis, and thrombus formation, and has limited efficacy in performing atrial linear ablation. As a result, new alterative energy sources have been explored for AF ablation. These new technologies, including cryoablation, microwave, ultrasound, and laser have different potential advantages over RF, but all of them have limited clinical experiences. Furthermore, the emergence of these new ablation energy sources should be paralleled with development of new ablation catheters, mapping and imaging tools to improve the successful rate of AF ablation. In the future, conventional RF ablation will remain the standard approach for AF, but some of these energies may be used in combination at specific sites for safety reasons, such as the use of cryoablation inside PVs or the use of microwave to create long atrial linear ablation more effectively.