Emerging PFA Technologies: Single‑Shot Systems, Focal Catheters, and Safety Signals

Pulsed field ablation (PFA) has rapidly emerged as a transformative technology in catheter ablation for atrial fibrillation, offering tissue-selective myocardial injury with minimal collateral damage. While the first clinical experience was dominated by single-shot systems enabling efficient pulmonary vein isolation with favourable safety profiles, new PFA technologies are expanding the therapeutic landscape. Single-shot platforms continue to evolve with improvements in energy delivery, catheter stability, and mapping integration. In parallel, focal PFA catheters have been introduced to address limitations of fixed shapes, enabling targeted lesion creation for complex substrates such as non-PV triggers, linear ablation, or adjunctive lesion sets in persistent AF, as well as ablation of ventricular arrhythmias.As adoption increases, accumulating real-world and trial data have highlighted both promising outcomes and emerging safety signals. Although major complications appear less frequent than with thermal energy, events such as haemolysis, coronary spasm, phrenic nerve dysfunction, and oesophageal irritation require continued vigilance. Understanding how different PFA systems, energy parameters, and procedural workflows influence efficacy and safety remains essential as the field transitions from early technology to widespread clinical practice.This Research Topic aims to provide a comprehensive and up-to-date overview of emerging pulsed field ablation (PFA) technologies, focusing on single-shot systems, focal catheters, and evolving safety considerations. Its primary goal is to highlight the rapid technological diversification within PFA and to clarify how these innovations may reshape interventional electrophysiology.We seek to:• Summarize current evidence on the performance, efficacy, and workflow of single-shot PFA systems;• Explore the role of focal PFA catheters in advanced lesion creation, substrate modification, and personalized ablation strategies;• Critically evaluate safety data across platforms, including emerging signals and mechanistic insights;• Compare PFA with traditional energy sources to define current advantages, limitations, and unmet clinical needs;• Provide expert perspectives on standardization, nomenclature, and reporting requirements as the field expands;• Identify future research priorities, including lesion durability, long-term outcomes, integration with mapping systems, and real-world registries.By uniting technological, clinical, and safety viewpoints, this Special Issue aims to guide clinicians, researchers, and industry partners in shaping the next generation of PFA-based ablation therapy.We look forward to receiving original research articles, reviews, and meta-analyses that aim to:• Summarize current evidence on the performance, efficacy, and workflow of single-shot PFA systems;• Explore the role of focal PFA catheters in advanced lesion creation, substrate modification, and personalized ablation strategies;• Critically evaluate safety data across platforms, including emerging signals and mechanistic insights;• Compare PFA with traditional energy sources to define current advantages, limitations, and unmet clinical needs;• Provide expert perspectives on standardization, nomenclature, and reporting requirements as the field expands;• Identify future research priorities, including lesion durability, long-term outcomes, integration with mapping systems, and real-world registries. Topic editors: Sorin Stefan Popescu, John Catanzaro, Jose Luis Merino, Daniel Scherr, John Silberbauer, Roland Tilz Source: https://www.frontiersin.org/research-topics/76507/emerging-pfa-technologies-single-shot-systems-focal-catheters-and-safety-signals