Chair Julian Chun (Frankfurt, DE) introduced the session, where case operator Gian Battista Chierchia (UZ Brussel, Brussels, BE) presented a pre-recorded case on balloon-based pulsed field ablation (PFA) using the Volk PFA system. Prof Chierchia detailed the system’s 28 mm expandable balloon, eight splines and impedance-based contact algorithm. He demonstrated lesion creation with real-time mapping, ensuring precise pulmonary vein isolation. The panel, including Arian Sultan (Cologne, DE) and Roland Tilz (Lübeck, DE), discussed the balloon’s advantages, such as superior contact and lesion durability, while acknowledging its bulkiness in smaller atria.

The discussion covered workflow adaptations, safety and procedural efficiency. The panel highlighted the system’s ability to integrate with 3D mapping without contrast and its role in reducing energy application in the blood pool, potentially minimising haemolysis. Durability in pulmonary vein isolation was noted as high, with the procedure typically lasting 30–60 minutes. Dr Sultan and Prof Tilz debated the device’s feasibility beyond pulmonary vein isolation, considering its potential for posterior wall ablation but limitations in linear lesions. The session concluded with a preview of an upcoming discussion on PFA safety.