Pulsed Field Ablation for Ventricular Arrhythmias: A Systematic Review and Single-Arm Meta-Analysis
Jiaqi Li1, Enyuan Zhang1, Shaobo Fan1
1Chest Hospital, Tianjin University, Tianjin, China.
Pacing and Clinical Electrophysiology : PACE
|March 31, 2026
Summary
Pulsed field ablation (PFA) shows promise for treating ventricular arrhythmias (VAs), achieving high acute success rates. However, its long-term efficacy is better for premature ventricular contractions (PVCs) than for ventricular tachycardia (VT).
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Pulsed field ablation (PFA) is an emerging nonthermal ablation modality.
- PFA offers deeper penetration through scar tissue, a challenge for existing therapies.
- Evidence for PFA in ventricular arrhythmias (VAs) is currently limited.
Purpose of the Study:
- To evaluate the safety and efficacy of PFA for treating VAs.
- To summarize existing research on PFA for premature ventricular contractions (PVCs) and ventricular tachycardia (VT).
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and Cochrane Library databases.
- Included studies evaluated PFA for VAs from inception to December 2025.
- A meta-analysis of single-arm studies assessed acute success, short- to mid-term success, and complication rates.
Main Results:
- Six studies involving 149 patients (84 with PVCs, 65 with VT) were analyzed.
- Overall acute success rate was 88%, with similar rates for PVCs (88%) and VT (90%).
- Short- to mid-term success was 73% overall, higher in PVCs (80%) than VT (63%), with a 15% perioperative complication rate.
Conclusions:
- PFA demonstrates good acute success and acceptable safety for VA treatment.
- Efficacy of PFA is higher for PVCs compared to VT in the short- to mid-term.
- Further research is needed to optimize PFA for VT ablation.
Keywords:
meta‐analysispremature ventricular contractionspulsed field ablationventricular arrhythmiasventricular tachycardiaMore Related Videos
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