Expanding indications for pulsed-field ablation beyond the treatment of cardiac arrhythmias?

Conventional septal reduction therapies including surgical myomectomy and alcohol septal ablation are not applicable to a significant proportion of patients with symptomatic obstructive hypertrophic cardiomyopathy because of their anatomical variations in the site of hypertrophy and availability of specialized centers and limited septal branches, respectively,1 and those procedures carry significant risks of heart block.2,3 As a result, different alternative septal reduction approaches, including transapical septal myomectomy,4 and even catheter-based radiofrequency ablation5 have been described.