Abstract: Catheter ablation has become the primary treatment for atrial fibrillation(AF). Compared with antiarrhythmic drugs, catheter ablation significantly reduces the recurrence rate of AF, lowers the mortality and cardiovascular hospitalization rates, and improves quality of life. Traditional ablation energies include cryoballoon ablation(cryo)and radiofrequency ablation(heat). The cryoballoon technology has evolved to its fourth generation,and radiofrequency ablation has developed a very high-power, short-duration(vHPSD)ablation mode based on force-sensing and multiport perfusion technologies. These technological innovations have further improved the efficiency and safety of catheter ablation procedures. New ablation energies include laser balloon ablation and pulsed field ablation(electroporation). These new energies have achieved good results in treating AF, especially in pulmonary vein isolation(PVI). Recently, pulsed field ablation(PFA)has become a popular technology in the field of catheter ablation due to its high efficiency and safety. PFA uses the electroporation effect and controls the electric field strength to selectively damage myocardial cells while avoiding injury to surrounding tissues, such as the phrenic nerve and esophagus. This review summarizes the latest clinical progress of four energy ablation technologies and compares their safety and effectiveness in AF ablation. Our results demonstrate that all four energies are suitable for PVI. PFA technology significantly reduces procedure time and the learning curve for operators,while also reduces the incidence of traditional complications, such as phrenic nerve and esophageal injury. However, confirmation of the long-term effectiveness and safety of new energies, as well as their application in structures outside the pulmonary veins, requires larger-scale and longer-term clinical studies.

Key words: Atrial fibrillation, Radiofrequency ablation, Cryoballoon ablation, Pulsed field ablation, Laser balloon ablation, Pulmonary vein isolation