A High‐Precision, Low‐Voltage Pulsed Field Ablation Device with Capability of Minimally Invasive Surgery

Abstract Pulsed field ablation is a novel approach to treating 33.5 million patients with atrial fibrillation and offers a tissue‐specific advantage over conventional radiofrequency ablation and cryoablation. However, for complex structural targets in the heart, current electrodes often damage non‐target areas due to inaccurate ablation and have to employ electrical pulses with amplitudes of several kilovolts. Herein, materials and designs of a catheter‐integrated microelectrode and sensors that can be used for high‐precision and low‐voltage pulsed field ablation through minimally invasive operation on a large animal model, is reported. The device with a new electrode configuration supports point‐by‐point ablation with a width of 3.8 mm (≈1/10 that of a typical ablation electrode) for individual lesions at the voltage of 300 V (an order of magnitude reduction compared to the current state‐of‐the‐art). More impressively, the integrated catheter allows for pulsed field ablation on the large animal heart through minimally invasive surgery and blocks the electrical conduction pathway on the heart, which is the key to treating atrial fibrillation. This catheter‐integrated device will enhance the efficiency and safety of pulsed field ablation, especially for complex cardiac structures, thus facilitating its move to the clinic.