Pulsed Field Ablation Pioneer Targets Ventricular Tachycardia with New Device

Steven Mickelsen, the electrophysiologist behind Boston Scientific's Farapulse pulsed field ablation (PFA) system, is now setting his sights on a new frontier in cardiac care. As CEO of Field Medical, Mickelsen is developing a PFA tool to treat ventricular tachycardia (VT), a potentially fatal arrhythmia that has long challenged clinicians.

From Atrial Fibrillation to Ventricular Tachycardia

Mickelsen's journey began with the founding of Farapulse in 2012, driven by a desire to make atrial fibrillation (AFib) ablation safer. The resulting PFA technology has since transformed AFib treatment, with Boston Scientific projecting that PFA will be used in over 60% of AFib procedures by 2026.

Building on this success, Mickelsen has turned his attention to VT, an arrhythmia that can lead to sudden cardiac death. "Now that everybody and their mother is going after AFib ablation, why aren't we addressing the people who are dying from VT?" Mickelsen explained, highlighting the unmet clinical need that inspired the creation of Field Medical.

FieldForce PFA: A New Approach to VT Treatment

Field Medical's FieldForce PFA device received the FDA's breakthrough device designation in December and was accepted into the agency's total product life cycle advisory program. The device aims to overcome the limitations of current VT treatments, which include toxic drugs and complex, time-consuming ablation procedures.

Mickelsen envisions transforming VT ablation into a 90-minute outpatient procedure for patients with implantable cardioverter defibrillators (ICDs). The FieldForce PFA catheter is designed to create full-thickness left ventricle lesions from inside the heart, potentially eliminating the need for external cardiac access and making the procedure more widely accessible.

"PFA is ideal because of the complex shape of the heart," Mickelsen noted. "The beauty of PFA is you can do it in a very clean way. It heals incredibly fast. Within two weeks or so, most of the ablation is well on its way to healing."

Democratizing VT Therapy

By addressing the technical challenges of VT ablation, Field Medical aims to democratize access to effective treatment. The FieldForce device is designed to handle like a familiar radiofrequency catheter, requiring minimal additional training for electrophysiologists.

As human testing of the FieldForce PFA device progresses, Mickelsen and his team at Field Medical are poised to potentially revolutionize VT treatment, much as Farapulse transformed the approach to AFib. This development represents a significant step forward in the ongoing evolution of cardiac care, offering new hope for patients facing life-threatening arrhythmias.