In this first-in-human trial, patients with scar-related ventricular tachycardia underwent high-voltage pulsed field ablation using a focal catheter system. Procedural endpoints included the creation of transmural lesions, suppression of arrhythmias, and absence of major adverse events. Imaging and electroanatomical mapping confirmed lesion completeness and transmurality. All patients tolerated the procedure without significant collateral tissue injury. Early results indicated effective control of ventricular tachycardia, suggesting that high-voltage pulsed field ablation may provide a safe and efficient alternative to traditional thermal ablation for complex arrhythmias associated with myocardial scar.
The authors highlight that while the initial results are promising, larger clinical trials with longer follow-up are needed to confirm long-term efficacy and safety. The potential advantages of this technique include reduced procedure times, decreased risk of damage to surrounding cardiac structures, and improved lesion consistency in scarred regions. This study provides a foundation for further investigation into high-voltage pulsed field ablation in ventricular arrhythmia management, offering hope for improved clinical outcomes in patients with scar-related ventricular tachycardia.
Keywords: high-voltage pulsed field ablation, ventricular tachycardia, scar-related arrhythmia, transmural lesion, cardiac electrophysiology, first-in-human study, focal ablation, Vivek Y. Reddy, Jacob S. Koruth, Petr Peichl, Jan Petru, Moritoshi Funasako, Jan Skoda, Keita Watanabe, Moritz Nies, Josef Kautzner, Petr Neuzil, Circulation
Reference:
Reddy V.Y., Koruth J.S., Peichl P., Petru J., Funasako M., Skoda J., Watanabe K., Nies M., Kautzner J., Neuzil P. High-Voltage Focal Pulsed Field Ablation to Treat Scar-Related Ventricular Tachycardia: The First-in-Human VCAS Trial. Circulation. 2025. doi:10.1161/CIRCULATIONAHA.125.077025
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