Pulsed field ablation for ventricular arrhythmias with pentaspline catheter

BackgroundCatheter ablation using pulsed-field energy may penetrate deeper into scarred tissue than thermal energies; however, evidence regarding its role in treating ventricular arrhythmias (VAs) is limited. In this prospective study, we report our current experience on pulsed field ablation (PFA)...

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Main Authors: Anna Padisak, Nándor Szegedi, Edit Tanai, Zoltán Salló, Klaudia Vivien Nagy, Péter Perge, Márton Boga, Gábor Orbán, Patrik Tóth, Ferenc Komlósi, Béla Merkely, László Gellér
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1631253/full
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author Anna Padisak
Nándor Szegedi
Edit Tanai
Zoltán Salló
Klaudia Vivien Nagy
Péter Perge
Márton Boga
Gábor Orbán
Patrik Tóth
Ferenc Komlósi
Béla Merkely
László Gellér
author_facet Anna Padisak
Nándor Szegedi
Edit Tanai
Zoltán Salló
Klaudia Vivien Nagy
Péter Perge
Márton Boga
Gábor Orbán
Patrik Tóth
Ferenc Komlósi
Béla Merkely
László Gellér
author_sort Anna Padisak
collection DOAJ
description BackgroundCatheter ablation using pulsed-field energy may penetrate deeper into scarred tissue than thermal energies; however, evidence regarding its role in treating ventricular arrhythmias (VAs) is limited. In this prospective study, we report our current experience on pulsed field ablation (PFA) with pentaspline catheter for the treatment of premature ventricular contractions (PVCs) originating from the right ventricular outflow tract (RVOT) and scar-related ventricular tachycardias (VTs).MethodsConsecutive VA patients who underwent PFA with Farapulse system were enrolled. Seven patients underwent ablation for idiopathic RVOT PVCs, and five patients with structural heart disease underwent ablation for scar-related VTs. The recurrence of arrhythmias was assessed by 24-hour Holter electrocardiography monitoring or implantable cardioverter defibrillator interrogation.ResultsTwelve patients were enrolled, age 51 ± 9 years, nine were men, four had previously failed radiofrequency ablation. Procedural and fluoroscopy times were 53 (41–105) minutes and 8 (4–20) minutes, respectively. The median number of PFA applications was 20 ± 13 in the VT group and 8 (7–8) in the PVC group. Acute procedural success was achieved in 92% (CI 62%–100%) of patients. During a mean follow-up of 100 (97–140) days, freedom from VT was 80% (CI 28%–99%), and a PVC burden <1% was achieved in 71% (CI 29%–96%) of patients.ConclusionThe ablation of idiopathic RVOT PVCs and scar-related VTs with the pentaspline PFA catheter is feasible, with good acute and mid-term efficacy observed in our cohort. Further research involving larger cohorts and longer follow-up periods is needed to analyze the safety and define the role of PFA in VAs.
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spelling doaj-art-b16a8e09cfa24eb988c72a655b56f2f02025-07-07T05:26:44ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.16312531631253Pulsed field ablation for ventricular arrhythmias with pentaspline catheterAnna PadisakNándor SzegediEdit TanaiZoltán SallóKlaudia Vivien NagyPéter PergeMárton BogaGábor OrbánPatrik TóthFerenc KomlósiBéla MerkelyLászló GellérBackgroundCatheter ablation using pulsed-field energy may penetrate deeper into scarred tissue than thermal energies; however, evidence regarding its role in treating ventricular arrhythmias (VAs) is limited. In this prospective study, we report our current experience on pulsed field ablation (PFA) with pentaspline catheter for the treatment of premature ventricular contractions (PVCs) originating from the right ventricular outflow tract (RVOT) and scar-related ventricular tachycardias (VTs).MethodsConsecutive VA patients who underwent PFA with Farapulse system were enrolled. Seven patients underwent ablation for idiopathic RVOT PVCs, and five patients with structural heart disease underwent ablation for scar-related VTs. The recurrence of arrhythmias was assessed by 24-hour Holter electrocardiography monitoring or implantable cardioverter defibrillator interrogation.ResultsTwelve patients were enrolled, age 51 ± 9 years, nine were men, four had previously failed radiofrequency ablation. Procedural and fluoroscopy times were 53 (41–105) minutes and 8 (4–20) minutes, respectively. The median number of PFA applications was 20 ± 13 in the VT group and 8 (7–8) in the PVC group. Acute procedural success was achieved in 92% (CI 62%–100%) of patients. During a mean follow-up of 100 (97–140) days, freedom from VT was 80% (CI 28%–99%), and a PVC burden <1% was achieved in 71% (CI 29%–96%) of patients.ConclusionThe ablation of idiopathic RVOT PVCs and scar-related VTs with the pentaspline PFA catheter is feasible, with good acute and mid-term efficacy observed in our cohort. Further research involving larger cohorts and longer follow-up periods is needed to analyze the safety and define the role of PFA in VAs.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1631253/fullcatheter ablationpulsed field ablationpentaspline catheterpremature ventricular contractionventricular tachycardiaright ventricular outflow tract
spellingShingle Anna Padisak
Nándor Szegedi
Edit Tanai
Zoltán Salló
Klaudia Vivien Nagy
Péter Perge
Márton Boga
Gábor Orbán
Patrik Tóth
Ferenc Komlósi
Béla Merkely
László Gellér
Pulsed field ablation for ventricular arrhythmias with pentaspline catheter
Frontiers in Cardiovascular Medicine
catheter ablation
pulsed field ablation
pentaspline catheter
premature ventricular contraction
ventricular tachycardia
right ventricular outflow tract
title Pulsed field ablation for ventricular arrhythmias with pentaspline catheter
title_full Pulsed field ablation for ventricular arrhythmias with pentaspline catheter
title_fullStr Pulsed field ablation for ventricular arrhythmias with pentaspline catheter
title_full_unstemmed Pulsed field ablation for ventricular arrhythmias with pentaspline catheter
title_short Pulsed field ablation for ventricular arrhythmias with pentaspline catheter
title_sort pulsed field ablation for ventricular arrhythmias with pentaspline catheter
topic catheter ablation
pulsed field ablation
pentaspline catheter
premature ventricular contraction
ventricular tachycardia
right ventricular outflow tract
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1631253/full
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