Paroxysmal Atrial Fibrillation - PFA to the rescue?

The very best I know of is Dr. Andrea Natale at the Texas Cardiac Arrythmia Institute in Austin. He travels and performs procedures in multiple hospitals in the west. He was trained by the Great Guru of all things ablation, Dr. Pierre Jais in Bordeaux, France. If you can travel, and don't mind waiting a few months, ...
https://www.drandreanatale.com/
I'm Canadian, and have had no interactions of any sort with Dr. Natale or any of his employees or colleagues. I'm just passing this on based on widespread admiration and reportedly astounding results over at affibers.org.

hi, have there been any clinical trials comparing hte PFA with other methods of ablation? Does anyone know the pros and cons of these different procedures? Thanks for any information.

Yes, this was done between the summer of 2022 and late2023. The results both approved the the novel PFA procedure and did a comparison for efficacy. A person just posted this result on another discussion topic:
https://www.medscape.com/viewarticle/pulsed-field-ablation-af-are-us-electrophysiologists-too-2024a1000d2v?form=fpf

I have had two cardiac ablations, one was a pulsed field ablation. In 2018 I had an ablation in Ocala, FL for supraventricular tachycardia, although I'm not sure if it was RF or cryo. At any rate it was 100% effective and (thankfully) I have not had the return of symptoms. On Wednesday, 7/24 I had a pulsed field ablation at Mayo Jacksonville to address paroxysmal afib and a premature atrial contraction burden in the 10-12% range. The doc was able to isolate the area causing the afib and completed that ablation. He isolated the area causing the PACs but because it was very close to the superior vena cava did not target it - concern for diaphragm activation and proximity to the SA node. The doc's notes state that if PAC appears to be symptomatic "would consider RFA ablation." I'm not sure why one would use RFA ablation in that situation rather than PFA. My follow up appointment is today and I'll ask. I have to say that I was very comfortable with the PFA process and the purported enhanced safety it provides, although I'm bummed that the PACs are still there.

It's because PFA is only, solely, approved for PVI. It's application method, meaning the implement design in this case, is not conducive to the same positioning as the RF needles. This is my understanding...I may be mistaken.

I have had two ablations. The first failed within 6 days and I was in a really bad way with 180 BPM. I was placed immediately on Amiodarone for eight weeks, got off it, was fine for two months, and then the AF reared up again. In between, I had a PAC burden in the 10% range, maybe more (I was never given a figure, but the outpatient nurse who held my hand over the phone more than once when I was getting very symptomatic admitted that the Holter two weeks after stopping Amiodarone showed, '...a LOT of PACs.' She emphasized 'lot' ). When my EP came to my bedside after the second ablation, he told me he had been zapping the third pulmonary vein when my heart went into firm NSR. They stood back, watched, and it was reliable. He didn't even have to cardiovert me before wheeling me out of the cath lab. He had found the one small gap he'd missed the first time. My PACs also went away, and I think you'll find the same thing. Those nasty thumps 'n bumps are for da boids. 😀