Arrhythmias & electrophysiology
Functional and electrical responses to ventricular pulsed field ablation: First human characterization of myocardial excitability kinetics
Authors' conclusion
Sequential ventricular PEF applications produce a stepwise reduction in myocardial excitability, whereas voltage attenuation shows an early plateau response. Assessment of myocardial capture during PEF delivery may represent a complementary intraprocedural marker associated with functional tissue response to PFA.
Study context
- Population
- Patients undergoing ventricular tachycardia (VT) ablation with the lattice-tip catheter89 datasets of applications (62 left ventricular, 27 right ventricular sites) · left ventricular sites 62 · right ventricular sites 27
- Participants
- 15 patients
- Exposure
- Myocardial capture across sequential pulsed electric field (PEF) applications, and its relationship with voltage reduction
- Outcome
- Myocardial captures across sequential applications
Methodological detailsprospectively enrolled, repeated-measures and correlation analyses
- Prospectively enrolled
- Repeated-measures and correlation analyses
Main finding
As reported in the abstract
- Myocardial captures, earlier application (median [interquartile range])
- 9 [interquartile range, 5-11]
- Myocardial captures, later application (median [interquartile range])
- 5 [interquartile range, 1-8]
- P
- P < .001
- Complete loss of capture achieved, share of sites
- 20%
Observational data: associations, not effects.
Further findings
Local voltage after the first application
- Immediate voltage reduction
- 49%
- P
- P < 0.0001
- Followed by an early plateau
Baseline voltage as predictor of complete loss of capture
- Area under the curve
- 0.57
- Did not predict complete loss of capture
Complete non-capture, right ventricle vs left ventricle
- Complete non-capture more frequent in the right ventricle
- P = 0.04
Original publication
Functional and electrical responses to ventricular pulsed field ablation: First human characterization of myocardial excitability kinetics. Heart Rhythm. Published 2 July 2026. doi:10.
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