Pulsed Electric Field Technology Treats Atrial Fibrillation

A novel atrial fibrillation (AF) ablation system uses non-thermal pulsed field ablation (PFA) technology to interrupt cardiac pathways and AF triggers.

The Medtronic (Dublin, Ireland) PulseSelect PFA System is designed to generate a train of high voltage, short duration, bipolar and biphasic pulsed electric fields in order to selectively target and ablate cardiomyocytes, while avoiding other types of tissue. The system can also be used for pulmonary vein isolation (PVI) treatments. A prospective, multi-center, non-randomized, worldwide trial called the PULSED AF study has been launched in the U.S., Australia, and Canada, to treat AF patients with the Medtronic PulseSelect PFA System.

“As a global leader in the treatment of cardiac arrhythmias, Medtronic is constantly evaluating new and existing therapies to better meet the needs of patients and the physicians who care for them,” said Rebecca Seidel, vice president and general manager of AF solutions, part of the cardiac and vascular group at Medtronic. “The PULSED AF study is another example of our commitment to meaningful innovation, and a major step forward in the development of a diverse set of therapy options for atrial fibrillation patients.”

“This new technology is potentially everything we've hoped for in catheter ablation. It's easier to use, more efficient, and will be better for patients because there's less risk of damage to surrounding tissue and a shorter recovery time,” said electrophysiologist John Hummel, MD, of Ohio State University (OSU; Columbus, USA), who performed the first procedure in the United States. “This type of energy delivery is non-thermal, and heart muscle cells are uniquely sensitive to it, thus helping to avoid affecting other types of tissue around the heart. It's also very rapid and will likely significantly cut down on surgery time.”

PVI is a catheter ablation technique developed to prevent focal triggers in the pulmonary veins from initiating episodes of persistent atrial fibrillation (PsAF). Although the procedure initially involved focal ablation with a catheter directly in the pulmonary veins, isolating the pulmonary veins by applying ablation energy at their junction with the left atrium is more effective. The PVI procedure is most suitable for patients whose recurring symptomatic episodes of AF have not been suppressed by anti-arrhythmic drugs or who do not wish to take long-term anti-arrhythmic or anticoagulation medications.

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