How does pulsed field ablation differ from RF ablation?

• A. PFA is selective and spares neighboring structures
• B. PFA uses thermal heating
• C. PFA causes non-selective necrosis
• D. PFA requires braces to apply energy

Answer: (A)

Pulsed field ablation works by irreversible electroporation: it delivers short, high-voltage electrical pulses that create pores in cell membranes, causing cell death without relying on heating tissue. Because this mechanism targets cellular membranes rather than heat diffusion, the ablation tends to be more selective for myocardial tissue while sparing nearby structures such as the esophagus, blood vessels, and nerves. Radiofrequency ablation, by contrast, relies on thermal heating to produce coagulative necrosis, and the heat can spread to adjacent tissues, increasing the risk of collateral injury. So the best description is that pulsed field ablation is selective and spares neighboring structures. The other statements don’t fit: it does not use thermal heating, it does not cause non-selective necrosis, and applying energy does not involve any special braces.