@cstrutt52 This is what we try to impart to people who visit us over on afibbers.org forum: It's a progressive disorder, and left untreated it becomes highly resistant to any interventions, including amiodarone, which is the 'drug of last resort', or even to ablations. Even pacemakers can't stop all AF because pacemakers are mostly, as far as I know, meant to control rapid ventricular response (RVR) during fibrillation, which can be exceedingly onerous for those muscles over time, and we're not talking weeks...days. Even so, pacing, the operations performed by a pacemaker, invites other problems as a recent paper I read suggests. If it is done poorly, inexpertly set up, or without frequent monitoring to ensure accuracy, it can cause as much of the same kind of damage as unchecked AF and RVR. So, the wisest of us soon understand that an early intervention is the best intervention when it comes to heart arrhythmias, but especially tachyarrhythmias, and most especially when there is clear RVR.

So, you are correct, as far as this non-expert can tell, that PFA is enjoying success at about the same rate as RF does, but in the 'right' hands....for both techniques. And I'm very optimistic that PFA will only get better, even if only marginally, as we do more of it and train other EPs to perform it. Until then, RF and PFA are neck-and-neck for successfully stopping AF (one full year after an ablation is the milestone for 'successful ablation), and PFA enjoys a better reputation for minimizing collateral tissue damage due to the nature of the energy being applied, but also HOW it's applied. That's where the skill, and experience, are key.