Pulsed electric field ablation (PFA) has been increasingly used as a non‐thermal alternative for treating atrial fibrillation (AFib). Consequently, computational modeling has been employed as an essential tool for understanding and optimizing PFA. Since irreversible electroporation (IRE), which controls PFA, is influenced by tissue-specific thresholds, pulse parameterisation, and anatomical variability, simulations have been created to account for these interdependencies. In this work, a thematic classification is proposed, derived through analysis of recent literature, in order to identify domains in which modeling plays a fundamental role. Six key areas are outlined: efficiency gains through limited-domain models, compensation for incomplete anatomical data, sex-specific personalization, observability of internal variables, refinement of IRE threshold reproducibility, and prediction of thermal effects. This framework synthesizes diverse modeling needs into a perspective that extends beyond previous reviews. As the field moves toward simulation-guided intervention planning, progress will depend on validation, clinical data availability, and standardized modeling practices. Rather than serving merely as a supportive technique, computational modeling emerges as a key enabler of faster, safer, and more cost-effective innovation in PFA.

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Modeling Matters: Computational Perspectives in Pulsed Electric Field Ablation for Atrial Fibrillation

  • Elma Kandić,
  • Madžida Hundur,
  • Aladin Brdar

摘要

Pulsed electric field ablation (PFA) has been increasingly used as a non‐thermal alternative for treating atrial fibrillation (AFib). Consequently, computational modeling has been employed as an essential tool for understanding and optimizing PFA. Since irreversible electroporation (IRE), which controls PFA, is influenced by tissue-specific thresholds, pulse parameterisation, and anatomical variability, simulations have been created to account for these interdependencies. In this work, a thematic classification is proposed, derived through analysis of recent literature, in order to identify domains in which modeling plays a fundamental role. Six key areas are outlined: efficiency gains through limited-domain models, compensation for incomplete anatomical data, sex-specific personalization, observability of internal variables, refinement of IRE threshold reproducibility, and prediction of thermal effects. This framework synthesizes diverse modeling needs into a perspective that extends beyond previous reviews. As the field moves toward simulation-guided intervention planning, progress will depend on validation, clinical data availability, and standardized modeling practices. Rather than serving merely as a supportive technique, computational modeling emerges as a key enabler of faster, safer, and more cost-effective innovation in PFA.