The hold-up is both cost and a break in the routinely successful actions that many EPs are enjoying with the other older methods. PFA doesn't result in an increase in index success....index meaning the first. First ablations only have about a 75% success rate except for the most highly skilled (and most highly sought/busiest) EPs who manage to get up to about 85%.

Yet another factor is that PFA is only currently authorized for a simple PVI (pulmonary vein isolation). The insertable implements are not currently suitable for ablating other areas commonly associated with AF, including the coronary sinus, the septum, and the left atrial appendage (LAA).

PFA is now widely available, just not as plentiful as Corn Flakes. For example, Drs. Santangeli at Cleveland Clinic and Natale at the Houston Cardiac Arrhythmia Institute both have done many of them.