Evaluating Autonomic Outcomes after Pulmonary Vein Isolation: the Differential Effects of Pulsed-Field and Radiofrequency Energy

The autonomic nervous system (ANS) plays a pivotal role in the onset and maintenance of atrial fibrillation (AF). During thermal ablation, the epicardial ganglionated plexi (GP) can inadvertently be affected, as indicated by a post-ablation increase in heart rate (HR) and decrease of heart rate variability (HRV), potentially impacting post-procedural outcomes. Pulsed‐field ablation (PFA) offers a safer and potentially more effective alternative, as lesion transmurality is not inversely related to safety as in thermal ablation.