Outcomes of Focal Pulsed Field Ablation for Paroxysmal Supraventricular Tachycardia

BACKGROUND:Pulsed field ablation (PFA) is primarily used for treatment of atrial fibrillation as it provides better safety and efficacy. However, there are limited data available on the utilization of PFA for paroxysmal supraventricular tachycardia (PSVT). The study sought to describe the outcomes of PSVT ablation with a novel focal contact force (CF)-sensing PFA. METHODS:In this first-in-human pilot study, a focal CF-sensing PFA catheter was used for mapping and ablation navigated with an electroanatomical mapping system (EAMS). Pulsed field energy was delivered as biphasic/bipolar electrical pulse trains with 2000 V/delivery. CF was controlled from 2 g to 10 g during PFA. RESULTS:Procedural acute success was achieved without general anesthesia or conscious sedation in all 10 patients, including 7 patients diagnosed with typical atrioventricular nodal reentrant tachycardias and 3 patients with orthodromic reciprocating tachycardias. Successful target ablation time was 2.0 ± 0.5 seconds/patient, and the acute procedural success at the first single site was achieved in 5 patients. The mean skin to skin procedure time was 79.4±15 min, PFA catheter dwell time was 50.1 ± 14min, and fluoroscopy time was 6.2 ± 7 min. Maintenance of sinus rhythm was observed in all patients within 6-month follow-up. No serious adverse events occurred in any subjects during PFA or during the 6-month follow-up. CONCLUSION:A focal CF-sensing PFA catheter could effectively, rapidly and safely ablate PSVT in conscious patients (ClinicalTrials.gov number, NCT05770921).