Irregular heart rhythms, or arrhythmias, affect millions of people worldwide and range from benign conditions to serious, life-threatening disorders. Left untreated, arrhythmias can increase the risk of strokes, heart failure, or sudden death. However, advances in medical technology have significantly improved the scope of treatments.
One of the most promising developments in recent years is pulsed-field ablation (PFA), a non-thermal method that uses electrical pulses to neutralise problematic cardiac tissue while preserving surrounding structures. Unlike traditional techniques, PFA offers speed, precision, and safety, heralding a new era in arrhythmia care.
Uses of pulsed-field ablation (PFA) are increasing in electrophysiology (EP) ablation procedures. GlobalData estimates suggest that around 1.7 million EP procedures took place in 2024, with 20% involving PFA. Yet by 2030, PFA use in EP ablation procedures is projected to account for 75%-80% of cases.
What is pulsed-field ablation?
To understand the advantages offered by PFA, it is essential to grasp the basics of arrhythmia treatment. The heart’s electrical system relies on precise signalling to maintain its regular rhythm. When this signalling is disrupted, the result is an irregular heartbeat.
Ablation procedures aim to target and destroy the small areas of cardiac tissue responsible for the erratic signals, restoring normal function. Historically, these procedures relied on either heat (radiofrequency ablation) or extreme cold (cryoablation) to achieve this goal. While effective, these methods come with risks such as collateral damage to surrounding structures, particularly in sensitive areas such as the oesophagus or the phrenic nerve.
In contrast, PFA represents a leap forward in safety and efficacy. Using high-voltage, short-duration electrical pulses, PFA induces electroporation – a process where cell membranes are temporarily permeabilised, leading to cell death in the targeted tissue. The technique is uniquely selective, affecting cardiac muscle cells while sparing nearby nerves, blood vessels, and other non-target tissues. This selectivity reduces the likelihood of complications and enhances patient recovery times.
How PFA works
Catheters used in PFA are designed with advanced materials to ensure precision and reliability. One critical advancement is the use of a nitinol core, an alloy of nickel and titanium known for its shape memory and super-elasticity. This unique property allows the catheter to navigate the intricate anatomy of the heart with ease, with the material returning to its original shape after bending or twisting. The flexibility ensures that the device can reach and treat problematic areas effectively.
Electrodes play a crucial role in delivering the pulses during PFA. E-plated electrodes, coated with specialised conductive materials, ensure efficient energy transfer while minimising the risk of overheating or degradation. These electrodes are engineered to maintain consistent performance throughout the procedure, a critical factor in achieving precise ablation.
Equally important are the transmitting wires that deliver electrical energy from the generator to the catheter. These wires must handle high voltages without compromising safety or efficiency. Advanced insulation and durable materials ensure that energy is delivered seamlessly, enabling the rapid, controlled bursts characteristic of PFA. Collectively, these components form a sophisticated system that enables physicians to perform the procedure with unprecedented control and confidence.
The future of pulsed-field ablation
For patients, the advent of PFA represents a significant improvement in the quality of care. Traditional ablation procedures often require lengthy recovery periods and carry a higher risk of complications. In contrast, PFA offers a minimally invasive solution with faster recovery times, allowing patients to return to their daily lives sooner. For those who have endured the debilitating symptoms of arrhythmia, such as palpitations, fatigue, and shortness of breath, the potential for a safer and more effective treatment is life changing.
Pulsed-field ablation marks a significant milestone in the treatment of irregular heartbeats. Its ability to target and neutralise faulty cardiac tissue with unparalleled accuracy offers hope to millions of patients worldwide. As we look to the future, the integration of advanced materials such as nitinol cores and e-plated electrodes highlights the importance of cutting-edge technology in revolutionising healthcare. With continued progress, PFA has the potential to become a cornerstone of arrhythmia treatment, ensuring that patients benefit from safer, faster, and more effective care.
Alleima, a leading partner of best-in-class medical device OEMs plays a critical role in the development of PFA by providing top-quality designs, a wide range of precision manufacturing capabilities and complex component solutions. Their expertise in nitinol, makes them an invaluable partner for PFA manufacturers. With over 20 years of experience in processing nitinol, Alleima ensures that manufacturers can optimize the performance of this crucial material. Additionally, their innovative electroplating techniques with conductive alloys enhance the efficiency and reliability of electrodes used in PFA procedures. The high-quality medical wires developed and produced by Alleima, are essential for transmitting energy, further underscore their commitment to safety, durability and precision.
For more information about Alleima’s engineering services, e-plating and wire offerings, please visit their website at www.alleima.com/medical. To learn more about Alleima’s specialist capabilities with nitinol, download the report below.
