@bohaiboy Not by any means. Not every EP feels they need to learn how to do PFA and to get certified to conduct such repairs. The very best EPs do both, but they still do RF if they feel it will suffice for their patients' purposes. I had two RF ablations three years ago by an excellent EP in British Columbia, and so far, fingers crossed, knock on wood, turn around counter-clockwise three times, I am free of both PACs and AF.

Is PFA becoming more popular, are more and more surgeons using it, and are the results getting better? Yes, to all three. PFA will probably become the go-to standard within a couple of years because it's generally safer, no need for a TEE in most cases. So, less risk too boot. But currently, as of about six months ago, the 'success rate' between RF and PFA is within two percentage points. This means it's not so much the technique but rather the operator...the EP counts most in a 'successful' ablation...meaning one full year free of the arrhythmia.

The companies making PFA equipment keep trialing and introducing new applicator tips that can fit into and ablate different areas. I believe the LAA was added just about 8 months ago, and surely other applicator tips will come that will allow them to ablate all six walls.