Pulsed field ablation (PFA) technology has been dominating the electrophysiology market.

According to key opinion leaders (KOLs) from Europe, most doctors now prefer to use PFA catheters over traditional ablation methods, which typically include thermal or cryo energy, because of PFA’s ability to create lesions nonthermally and within milliseconds.

PFA catheters are only commercially available in Europe. However, the number of patients treated with these catheters in Europe alone experienced a compound annual growth rate (CAGR) of 254% from 2021 to 2023.

Currently, only two PFA systems are commercially available—Boston Scientific’s Farapulse and Medtronic’s Affera Mapping Systems. Biosense Webster is also trying to enter this lucrative market with its own PFA system, the Veripulse. However, unlike the other two catheters, the Veripulse has not yet received any form of regulatory approval and is still in the early stages of clinical trials.

PFA catheters are indicated to treat atrial fibrillation (Afib) during electrophysiology procedures. Interestingly, another device, Boston Scientific’s Watchman FLX, which is used during left atrial appendage occlusion (LAAO) procedures, has been shaking up the Afib space. Between 2018 and 2022, the number of patients implanted with a Watchman FLX grew by almost 234%.

However, despite this aggressive CAGR, electrophysiology procedures still far exceed the number of LAAO procedures. The electrophysiology market still had the highest share in terms of the number of Afib treatment procedures, at 52% in 2022. PFA technologies are the current market leader and most preferred treatment for Afib in the electrophysiology space.