[News] A Chinese hospital successfully completed the first RhythPulse-PFA pulse ablation surgery in the country

marine1891
Aug 21
5 min read

On August 8, 2025, the team led by President Hua Junyi and Director Hu Pengfei, with Professor Wang Hao, at Zhejiang Chinese Medical University Second Affiliated Hospital (ZCMU Second Hospital), successfully performed an atrial fibrillation (AF) pulse ablation surgery using the RhythPulse® Pulsed Field Ablation (PFA) catheter developed by Xuanyu Medical. This successful procedure marks a significant milestone, as ZCMU Second Hospital’s Cardiology Department has now incorporated PFA technology into its routine clinical practice. This advancement brings a safer and more efficient treatment option to patients in the region suffering from atrial fibrillation.

Patient Information

The patient, an 84-year-old female, had been experiencing recurrent palpitations and dizziness for over two months, with symptoms worsening in the last day. After developing rapid atrial fibrillation, pharmacological cardioversion resulted in significant sinus bradycardia and junctional escape rhythm. The use of isoproterenol stabilized her condition, and the medication was gradually tapered off. Her sinus rhythm stabilized at 60–70 beats per minute, ruling out sick sinus syndrome. The diagnosis was confirmed as paroxysmal atrial fibrillation and paroxysmal atrial flutter.

After thorough discussion, the team led by President Hua Junyi, Director Hu Pengfei, and Professor Wang Hao determined that while traditional radiofrequency ablation is effective, its thermal energy could pose potential risks of injury to nearby structures such as the esophagus, nerves, and cardiac conduction system. This risk was particularly significant given the patient’s intolerance to radiofrequency-related pain, low body weight, and advanced age. After detailed communication with the patient and her family, the decision was made to proceed with Pulsed Field Ablation (PFA) technology.

Surgical Procedure

Before surgery, the patient was intolerant to transesophageal echocardiography. Instead, a CT scan was used to rule out left atrial appendage thrombus and to perform a three-dimensional reconstruction of the pulmonary vein anatomy.

During surgery, the procedure was conducted under local anesthesia with sedation, guided by a three-dimensional mapping system. The RhythPulse catheter (15mm annular diameter) from Xuanyu Medical was used to perform bilateral pulmonary vein isolation and posterior wall isolation, achieving bidirectional conduction block. During the procedure, a stable 2:1 conduction atrial flutter was induced, identified as mitral isthmus-related through mapping. The first discharge at the mitral isthmus restored sinus rhythm, and after four discharges, bidirectional conduction block was achieved, confirmed by pacing validation. The total procedure time was approximately 90 minutes, with catheter manipulation and discharge taking only 40 minutes. No complications occurred, and the surgery was successfully completed.

Surgical results

PFA (Pulsed Field Ablation) Technology Technical Principle

Pulsed Field Ablation (PFA) is a revolutionary non-thermal ablation technology introduced this year. It utilizes short-duration, high-voltage electrical pulses (on the microsecond scale) to create irreversible “nanoscale pores” (electroporation) in cell membranes, leading to cell apoptosis and achieving ablation. By exploiting the differing responses of various tissues to electric fields, cardiac PFA can precisely target myocardial cells while sparing surrounding nerves, blood vessels, and other structures from permanent damage. This technology provides a new approach to addressing the limitations of traditional ablation methods.

Advantages Over Traditional Radiofrequency and Cryoablation

PFA technology offers the following significant benefits:

Greater Precision: PFA specifically targets myocardial cells, with minimal impact on surrounding structures like the esophagus, phrenic nerve, and coronary arteries, significantly reducing the risk of complications. This is due to the varying sensitivity of different tissue cells to electric fields, with myocardial cells undergoing irreversible electroporation at specific field strengths, while other tissues remain relatively unaffected.
Higher Efficiency: PFA’s discharge time is extremely short, typically on the microsecond or nanosecond scale, allowing ablation to be completed rapidly and reducing overall procedure time. Additionally, PFA creates uniform, transmural ablation lesions, effectively blocking abnormal electrical signals, improving treatment outcomes, and lowering the recurrence rate of atrial fibrillation.
Enhanced Safety: As a non-thermal technology, PFA avoids complications associated with thermal damage, such as esophageal fistula or phrenic nerve paralysis, commonly seen in traditional ablation methods.

Expert Profiles

*Hua Junyi, Zhejiang Chinese Medical University Second Affiliated HospitalMD, Chief Physician*

Standing Committee Member of the Brain-Heart Co-Treatment Committee and Cardiac
Intervention Committee of the Chinese Medical Association’s Integrative Medicine Branch
Youth Committee Member of the Chinese Association of Integrative Medicine’s Geriatric Disease Committee
Standing Committee Member of the Zhejiang Provincial Committee
Youth Committee Member of the Zhejiang Medical Association’s Cardiovascular Committee
Bachelor’s degree from Zhejiang Medical University
Master’s from West China Medical University, Doctorate from Zhejiang University
Visiting Scholar at the University of Munich

With extensive experience in clinical cardiovascular care。

Dr. Hua specializes in the diagnosis and treatment of coronary heart disease, acute myocardial infarction, heart failure, myocarditis, cardiomyopathy, various arrhythmias, and hypertension. He is highly skilled in coronary interventions, pacemaker implantation, defibrillator implantation, and CRTD/P implantation, having performed nearly 10,000 cardiac intervention procedures. Dr. Hua has made significant contributions to the establishment and development of the “Zhejiang North Cardiovascular and Cerebrovascular Disease Center.” He has led multiple research projects, earning two Zhejiang Provincial Science and Technology Achievements, several Zhejiang Medical and Health Science and Technology Awards, and Zhejiang Chinese Medicine Science and Technology Awards. He has published over 20 academic papers in top-tier domestic and SCI-indexed journals in recent years.

*Hu Pengfei, Director of Cardiology, Zhejiang Chinese Medical University Second Affiliated Hospital*

Chief Physician, Master’s Degree Advisor
Member of the Zhejiang Electrophysiology and Pacing Committee
Member of the Zhejiang Chinese Medicine Association’s Cardiology Committee
Member of the Zhejiang Association of Integrative Medicine’s Cardiovascular Committee

With nearly 20 years of experience in cardiovascular disease management, Dr. Hu specializes in the diagnosis, treatment, and rehabilitation of coronary heart disease, hypertension, cardiomyopathy, heart failure, and arrhythmias. He is proficient in common cardiovascular diseases and coronary interventions. Dr. Hu has published over 30 academic papers, including more than 10 SCI-indexed papers, and has led one Zhejiang Natural Science Foundation project and five provincial-level projects.

*Wang Hao, Zhejiang Chinese Medical University Second Affiliated HospitalAssociate Chief Physician*

Standing Committee Member of the Hangzhou Electrophysiology and Pacing Society
Youth Committee Member of the Zhejiang Chinese Medicine Association’s Cardiology Committee
Member of the Electrophysiology Group of the Zhejiang Medical Association’s Electrophysiology and Pacing Committee.

With many years of experience in cardiology, specializing in catheter ablation interventions for arrhythmias, proficient in radiofrequency ablation for supraventricular tachycardia, atrial tachycardia, atrial fibrillation, ventricular tachycardia, and left atrial appendage closure procedures.

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