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Initial UK Experience of Focal Pulsed Field Ablation
Waqas Ullah1,2, Daniel Raine3, Maciej Debski3
1Cardiology Department, University Hospital Southampton, Southampton, UK.
Pacing and Clinical Electrophysiology : PACE
|December 22, 2025
Summary
Pulsed field ablation (PFA) using conventional catheters shows promise for atrial and ventricular arrhythmias. While effective for atrial flutter and ectopics, optimizing waveforms is needed for ventricular tachycardia ablation.
Area of Science:
- Electrophysiology
- Cardiovascular Interventions
- Medical Device Technology
Background:
- Pulsed field ablation (PFA) presents potential safety and efficacy benefits for catheter ablation procedures.
- Utilizing existing contact force sensing catheters and mapping systems for PFA delivery enhances familiarity and accessibility.
Purpose of the Study:
- To evaluate the feasibility and short-term outcomes of focal PFA delivered through conventional contact force sensing catheters in a multicenter setting.
- To assess the learning curve and procedural efficiency of PFA when using familiar equipment.
Main Methods:
- Retrospective data analysis of 112 cases undergoing focal PFA with conventional contact force sensing catheters across four centers.
- Focus on atrial tachycardia/atrial fibrillation, cavotricuspid isthmus (CTI), and mitral valve isthmus (MVI) ablations, as well as ventricular ablations.
Main Results:
- High acute success rates for atrial and CTI/MVI ablations; one MVI failure to block.
- Short-term success rates of 74% for atrial and 63% for ventricular ablations (45% VT, 100% VE).
- No learning curve observed based on center case volume; low complication rates including one stroke and one tamponade.
Conclusions:
- Focal PFA is versatile with conventional equipment, eliminating learning curves.
- Encouraging short-term efficacy for atrial and ventricular ectopics; waveform optimization may benefit ventricular tachycardia.
- Further investigation via randomized trials is warranted to confirm success and complication rates.
