Focal pulsed field ablation achieved acute procedural success in 95% of cases for complex ventricular arrhythmias, with a 15% complication rate and 50% arrhythmia recurrence over 663 days.
Observational (n=20)
No
Does focal pulsed field ablation achieve acute procedural success and safety in patients with complex ventricular arrhythmias?
Focal pulsed field ablation is a feasible bail-out or redo strategy for complex ventricular arrhythmias, yielding 95% acute procedural success but a 50% long-term recurrence rate.
Background Pulsed field ablation (PFA) has emerged as a novel non-thermal energy source for catheter ablation. While its use in atrial arrhythmias has expanded rapidly, clinical experience with ventricular PFA remains limited. Objective This study aimed to evaluate the feasibility, safety, and clinical outcomes of focal PFA for the treatment of complex ventricular arrhythmias. Methods This single-center observational study included patients undergoing catheter ablation for ventricular arrhythmias using focal PFA. The study population consisted of patients with challenging arrhythmia substrates, including redo procedures and cases requiring an intraprocedural switch from conventional radiofrequency ablation to focal PFA as a bail-out strategy. Acute procedural success, complications, and arrhythmia recurrence during follow-up were assessed. Results A total of 20 patients underwent ventricular PFA. Acute procedural success, defined as elimination of the target premature ventricular complex or noninducibility of sustained monomorphic ventricular tachycardia, was achieved in 95% of cases. During a mean follow-up of 663 ± 318 days, arrhythmia recurrence occurred in 10 patients (50%), including 6 of 9 (67%) with ventricular tachycardia and 4 of 11 (36%) with premature ventricular complexes. The overall complication rate was 15%, including one major vascular complication and two minor complications. Conclusion Focal PFA demonstrated high acute procedural success and an acceptable safety profile in complex ventricular arrhythmias. These findings support its feasibility as an additional energy modality in challenging substrates. Larger prospective studies are needed to further define its role and long-term efficacy.
Weyand et al. (Mon,) conducted a observational in Complex ventricular arrhythmias (n=20). Focal pulsed field ablation was evaluated on Acute procedural success (elimination of the target premature ventricular complex or noninducibility of sustained monomorphic ventricular tachycardia). Focal pulsed field ablation achieved acute procedural success in 95% of cases for complex ventricular arrhythmias, with a 15% complication rate and 50% arrhythmia recurrence over 663 days.