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. 2025 Jul 7:12:1631253.
doi: 10.3389/fcvm.2025.1631253. eCollection 2025.

Pulsed field ablation for ventricular arrhythmias with pentaspline catheter

Anna Padisak  1 , Nándor Szegedi  1 , Edit Tanai  1 , Zoltán Salló  1 , Klaudia Vivien Nagy  1 , Péter Perge  1 , Márton Boga  1 , Gábor Orbán  1 , Patrik Tóth  1 , Ferenc Komlósi  1 , Béla Merkely  1 , László Gellér  1
Affiliations

Pulsed field ablation for ventricular arrhythmias with pentaspline catheter

Anna Padisak et al. Front Cardiovasc Med. .

Abstract

Background: Catheter 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).

Methods: Consecutive 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.

Results: Twelve 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.

Conclusion: The 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.

Keywords: catheter ablation; pentaspline catheter; premature ventricular contraction; pulsed field ablation; right ventricular outflow tract; ventricular tachycardia.

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Conflict of interest statement

NS and LG report consulting fees from Biosense Webster, Abbott, and Boston Scientific, which are unrelated to the present study. ZS and KN report consulting fees from Abbott and Boston Scientific, which are unrelated to the present study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Fluoroscopy image (antero-posterior view) of the pentaspline catheter in “basket” configuration with intracardiac echocardiography catheter in the right ventricular outflow tract (A) and right atrium (B).
Figure 2
Figure 2
Intracardiac echocardiography image of the pentaspline catheter in “basket” configuration, right ventricular outflow tract view (A) and mid-right atrium—“home” view (B).
Figure 3
Figure 3
Fluoroscopy image showing the pentaspline catheter deployed in flower configuration at the apico-septal region (A) and infero-apical region (B) of the left ventricle.
See this image and copyright information in PMC

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