Severance Hospital performs 1,000th pulsed field ablation, first among South Korean medical institutions

Severance Hospital announced Thursday that its cardiovascular center has become the first medical institution in South Korea to perform 1,000 pulsed field ablation (PFA) procedures for the treatment of atrial fibrillation.

The milestone comes roughly one year and seven months after the hospital carried out the country's first PFA procedure in December 2024. It signals that the technique has moved well beyond an early-adoption phase and is rapidly becoming a standard part of atrial fibrillation care.

Atrial fibrillation is an arrhythmia in which the atria beat irregularly and rapidly. It can cause palpitations, shortness of breath and dizziness, and if left untreated, raises the risk of stroke and heart failure.

PFA uses brief, high-voltage electrical pulses to selectively destroy the heart muscle cells responsible for triggering atrial fibrillation. The pulses create microscopic pores in cell membranes, blocking the abnormal electrical signals that cause the condition.

Unlike conventional ablation methods that rely on heat or cold energy, PFA reduces the risk of damage to surrounding structures such as blood vessels, nerves and the esophagus. Procedures typically take about an hour, lowering the burden on patients.

PFA systems are categorized by the device and energy-delivery method used — including Farapulse, Varipulse and PulseSelect — each of which differs in catheter design and the way electrical pulses are delivered. Physicians select the most appropriate system based on a patient's cardiac anatomy, the type of atrial fibrillation and prior procedure history.

Severance Hospital's cardiovascular center has also maintained a strong safety record alongside its high procedure volume. No life-threatening complications have occurred to date, with stroke in 0.2 percent of cases, cardiac tamponade in 0.4 percent and vascular complications in 0.2 percent — outcomes better than those typically seen with radiofrequency or cryoballoon ablation.

Jeong Bo-young, director of the arrhythmia center at Severance Hospital's cardiovascular center and a professor of cardiology, said the 1,000-case milestone represents more than a rise in procedure numbers. "It reflects how we have refined our treatment strategies and safety protocols by applying PFA to a wide range of patients, including elderly individuals and those with multiple comorbidities," she said.

Professor Yoo Hee-tae said PFA offers a fast and effective way to eliminate the heart muscle cells causing arrhythmia while minimizing damage to surrounding tissue. "As our experience accumulates, our personalized approach — selecting the right device and defining the treatment scope based on each patient's condition — is becoming increasingly precise," he said.

The cardiovascular center is also leading the domestic rollout of PFA and the training of medical staff. Last year, it became the first institution in South Korea designated as a domestic and international training center for Farapulse and Varipulse, and has since hosted physicians from university hospitals across the country — including Kyungpook National University Hospital — as well as faculty from China, Hong Kong and Singapore for procedure observation and training.

Building on its accumulated procedural data, Severance plans to establish clearer criteria for device selection and treatment scope based on patient characteristics, and to develop standardized treatment strategies suited to South Korean patients.

"Drawing on 1,000 cases, we will establish PFA treatment standards tailored to Korean patients and provide safe, effective care even for those with complex atrial fibrillation," Jeong said. "We will also share our clinical experience with medical professionals at home and abroad to contribute to the standardization and advancement of PFA."