Deyang People's Hospital Successfully Performs China's First Batch of XuanYu Medical RhythPulse® PFA Ablation Surgeries

The patient who underwent this surgery was an elderly individual suffering from atrial fibrillation and also diagnosed with angina, coronary heart disease, emphysema, and chronic heart failure. Prior to the procedure, the cardiology team conducted a comprehensive evaluation of the patient’s condition, including electrocardiogram, echocardiography (especially transesophageal echocardiography to rule out thrombosis in the left atrium and left atrial appendage), and CT three-dimensional reconstruction (to obtain detailed information about cardiac structure and pulmonary vein anatomy). Considering the patient's significant symptoms, poor response to medication, the need for catheter ablation, and high acceptance of new technology, the cardiology team, after thorough assessment and multidisciplinary discussion, determined that the patient was an ideal candidate for PFA surgery. PFA, as an emerging ablation technology, uses high-energy electrical pulses to destroy abnormal myocardial tissue, block abnormal electrical signal conduction, and restore normal heart rhythm. It offers unique advantages such as tissue selectivity, excellent safety, and high surgical efficiency.

The surgery was performed under the precise control of Professor Lei Yu, utilizing ShineyoMedical's RhythPulse® system large loop catheter (20mm diameter, chosen due to the patient’s larger heart and wider pulmonary veins), in conjunction with Abbott’s 3D electrophysiological mapping system for rough modeling of the left atrium and substrate mapping. This further enhanced the precision and safety of the procedure. Subsequently, the ShineyoMedical RhythPulse® pulsed ablation catheter was positioned at the ostia and vestibule areas of the pulmonary veins with the assistance of a conventional steerable sheath. Four sets of pulses were delivered at the ostia and vestibule of each pulmonary vein.

During the procedure, based on the anatomical structure of the pulmonary veins, the corresponding catheter shape, and dynamic impedance changes, individual electrodes were controlled for discharge in real time while continuously monitoring and adjusting the catheter position and discharge parameters. Using the pulsed ablation system, a precise and controllable pulsed electric field energy was delivered to the target myocardial tissue to rapidly complete circumferential pulmonary vein ablation and achieve electrical isolation of the pulmonary veins (PVI). Due to the relatively large size of the two upper pulmonary veins in this patient, particular attention was paid to addressing the potentials between the two lungs. The top of the left atrium and the posterior wall of the left atrium were also treated until all target areas reached an electrical isolation state.

Total operation time was controlled within 90 minutes, with PFA ablation time kept under 30 minutes, reducing the overall procedure time by approximately 120 minutes compared to traditional surgery. During the operation, the patient experienced no muscle twitching under general anesthesia, maintained stable hemodynamics, and had no complications throughout. Under ICE monitoring, no bubbles were observed during the ablation process; circular catheter recordings showed disappearance of electrical potentials within the pulmonary veins, along with both entrance and exit block, confirming successful bilateral pulmonary vein isolation (PVI). The ablation line was complete without any conduction, marking a successful conclusion to the surgery as the arrhythmia focus was precisely eliminated!