HRS Releases Scientific Statement on Pulsed Field Ablation for Cardiac Arrhythmias

HRS-led document, developed in collaboration with EHRA, provides practical guidance on safety, workflow, and evolving technology in pulsed field ablation

Washington, D.C., February 12, 2026 – The Heart Rhythm Society (HRS) released today the 2026 HRS/EHRA Scientific Statement on Pulsed Field Ablation for Cardiac Arrhythmias, developed by HRS in collaboration with the European Heart Rhythm Association (EHRA).

Pulsed field ablation (PFA) has rapidly emerged as one of the most significant advances in catheter ablation. Unlike traditional thermal approaches such as radiofrequency or cryoablation, PFA uses high-voltage electrical pulses to induce irreversible electroporation of myocardial cells.

Since its clinical introduction, PFA has been adopted at unprecedented speed, with hundreds of thousands of procedures performed worldwide.

Clinical studies suggest that PFA offers procedural efficiency and favorable collateral tissue safety while maintaining efficacy comparable to established energy sources for atrial fibrillation (AF). However, as emphasized in the statement, the technology introduces distinct biophysical mechanisms and unique safety considerations that require careful understanding.

“Pulsed field ablation represents a fundamental shift in catheter ablation technology,” said Atul Verma, MD, FHRS, chair of the writing committee. “Given the rapid pace of adoption and the evolving clinical data, this statement helps clinicians interpret current evidence and implement PFA thoughtfully.”

The scientific statement provides practical, evidence-informed recommendations addressing:

• The biophysics of electroporation and key waveform parameters
• Clinical applications of PFA, including pulmonary vein isolation and other arrhythmias
• Procedural workflow considerations including anesthesia strategies, contact assessment, imaging, mapping integration and system-specific differences.
• Safety considerations such as hemolysis, coronary vasospasm, delayed coronary events and malignant arrhythmias that can occur minutes to days after the procedure often associated with a high number of PFA applications, and device interactions
• System-specific variability, highlighting that PFA platforms differ substantially in catheter design, waveform characteristics, and polarity.
• A major highlight of the statement is a formal call for minimal technical disclosure from manufacturers to allow for scientific comparison between PFA systems.

Although PFA may reduce certain risks associated with thermal ablation, the writing committee emphasizes that it introduces new safety considerations requiring thoughtful implementation.

“Every new energy source comes with its own learning curve,” said Mélèze Hocini, MD, FHRS, vice chair of the writing committee. “Understanding electric field dynamics, dosing strategies and system-specific safety profiles is critical to optimizing patient outcomes and avoid unintended consequences.”

As PFA technologies continue to evolve and expand into broader clinical use, the statement aims to help clinicians navigate differences among systems, recognize potential procedural risks, and apply best practices in real-world settings.

While not a formal clinical practice guideline, the scientific statement includes recommendations informed by available evidence and the collective clinical experience of the writing committee.

Funding: This scientific statement was developed without commercial support; the authors volunteered their time to the writing and review efforts.

Disclosures: Please see the article for a full list of author and peer reviewer disclosures.

Additional Resources

• View the manuscript online in Heart Rhythm
• The document will be presented at Heart Rhythm 2026 during the session “The 2026 Heart Rhythm Society Scientific Statement on Pulsed Field Ablation for Cardiac Arrhythmias” on April 25, 2026 at 9:30 am CT
• This scientific statement was developed in accordance with the HRS Scientific Documents Methodology Manual and policies

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About the Heart Rhythm Society

The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients and is the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal healthcare policies and standards. Incorporated in 1979 and based in Washington, D.C., it has a membership of more than 9,000 heart rhythm professionals from 94 countries. For more information, visit www.HRSonline.org.