Which cells are mainly targeted by PFA due to their electroporation threshold?

The primary target of Pulsed Field Ablation (PFA) is atrial cardiomyocytes, primarily due to their specific electroporation threshold. Cardiomyocytes, particularly those in the atria of the heart, demonstrate a particular susceptibility to the electric fields produced during PFA, which leads to controlled cell death while preserving surrounding tissues. This ability to select cardiomyocytes is crucial in the context of cardiac ablation procedures, where the goal is to eliminate abnormal electrical pathways contributing to arrhythmias.

PFA utilizes high-voltage, short-duration electrical pulses to induce permanent electroporation in the target cells. Atrial cardiomyocytes are ideally situated in such a manner that allows for the desired outcomes of electrical isolation without significant damage to adjacent structures, such as vascular endothelial cells, fibroblasts, or neuronal cells. By setting the parameters of the procedure to align with the electroporation thresholds specific to atrial tissue, practitioners can efficiently target and ablate the problematic areas of the heart, which is pivotal in treating arrhythmias effectively.