Atrial fibrillation (AF) poses a serious healthcare burden on society due to its high morbidity and the resulting serious complications such as
thrombosis and
heart failure. The principle of
catheter ablation is to achieve electrical isolation by linear destruction of cardiac tissue, which makes AF a curable disease. Currently,
catheter ablation does not have a high long-term success rate. The current academic consensus is that
inflammation and
fibrosis are central mechanisms in the progression of AF. However, artificially caused inflammatory cell death by
catheter ablation may have a significant impact on structural and
electrical remodeling, which may affect the long-term prognosis. This review first focused on the inflammatory response induced by apoptosis,
necrosis, necroptosis, pyroptosis, ferroptosis and their interaction with
arrhythmia. Then, we compared the differences in cell death induced by
radiofrequency ablation, cryoballoon ablation and pulsed-field ablation. Finally, we discussed the structural and
electrical remodeling caused by
inflammation and the association between
inflammation and the recurrence of AF after
catheter ablation. Collectively, pulsed-field ablation will be a revolutionary innovation with faster, safer, better tissue selectivity and less inflammatory response induced by apoptosis-dominated cell death.