In the latest episode of Arrhythmia Academy’s Journal Club, Dr Serge Boveda (Clinic Pasteur, FR) is joined by Professor Andrea Sarkozy (Brussels South University Hospital, BE) to explore the evolving role of pulsed field ablation (PFA) in the treatment of ventricular arrhythmias.

The discussion focuses on the potential of PFA as a novel energy source in the ventricle, examining its ability to penetrate scarred myocardium, achieve greater lesion depth, and reduce application times in anatomically challenging locations such as the papillary muscles and moderator band. Prof Sarkozy and Dr Boveda also address current limitations, including restricted dosing flexibility, lesion depth ceilings with repeated applications, and the need for improved integration with contemporary mapping systems.

Prof Sarkozy reviews outcomes with both focal and large-footprint PFA systems, outlining the scenarios where large-footprint PFA may offer clear advantages over radiofrequency ablation and emphasising the continued role of RF as a complementary energy source in selected settings. The episode concludes with a forward-looking discussion on how PFA may reshape ventricular ablation strategies as technology and dosing control continue to evolve.

Recorded remotely from Brussels and Toulouse, 2025.