First-in-Human Study Shows Promise for High-Voltage PFA in Treating Scar-Related ventricular tachycardia: Study

Written By : Dr. Shravani Dali Published On 2025-10-23T21:15:39+05:30 | Updated On 23 Oct 2025 9:16 PM IST

According to a new study, a high-voltage pulsed field ablation catheter effectively created transmural ventricular lesions, offering a potential new approach for managing scar-related ventricular tachycardia. Ventricular tachycardia associated with myocardial scarring is a challenging arrhythmia to treat, often requiring complex catheter ablation procedures that carry risks such as collateral tissue damage and incomplete lesion formation. Pulsed field ablation delivers high-voltage electrical pulses in very short durations, selectively affecting myocardial tissue while sparing surrounding structures. This approach may enhance procedural safety and efficacy, particularly in patients with scarred myocardium where conventional radiofrequency or cryoablation techniques can be less predictable.

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

high-voltage pulsed field ablationventricular tachycardiascar-related arrhythmiatransmural lesioncardiac electrophysiologyfirst-in-human studyfocal ablationVivek Y. ReddyJacob S. KoruthPetr PeichlJan PetruMoritoshi FunasakoJan SkodaKeita WatanabeMoritz NiesJosef KautznerPetr NeuzilCirculation

Source : Circulation

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.