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Catheter-based ablation techniques have a well-established role in atrial fibrillation (AF) management. The prevalence and impact of AF is increasing globally, thus mandating an emphasis on improving ablation techniques through innovation. One key area of ongoing evolution in this field is the use of laser energy to perform pulmonary vein isolation during AF catheter ablation. While laser use is not as widespread as other ablation techniques, such as radiofrequency ablation and cryoballoon ablation, advancements in product design and procedural protocols have demonstrated laser balloon ablation to be equally safe and effective compared to these other modalities. Additionally, strategies to improve procedural efficiency and decrease radiation exposure through low fluoroscopy protocols make this technology an increasingly promising and exciting option.

The Fourth Industrial Revolution, characterized by an unprecedented fusion of technologies that is blurring the lines between the physical, digital, and biological spheres, continues the trend to manufacture ever smaller mechanical, optical and electronic products and devices. In this manuscript, we outline the way cardiac implantable electronic devices (CIEDs) have evolved into remarkably smaller units with greatly enhanced applicability and capabilities.