A prospective observational study evaluated the efficacy and safety of focal pulsed-field ablation (PF) for ventricular arrhythmias (VAs) in 44 patients (16 women, aged 61 ± 14 years) with either frequent ventricular premature complexes (VPCs, 48%) or scar-related ventricular tachycardia (VT, 52%). Ablation was performed using an irrigated 4 mm tip catheter and a commercially available PF generator. On average, 16 ± 15 PF applications (25 A) were delivered per patient. Acute success was achieved in 84% of patients, with 81% achieving elimination of VPC and 83% achieving non-inducibility of VT. At 3-month follow-up, 81% of patients with VPC had persistent suppression of VPC, and 52% of patients with scar-related VT remained free of any VA. However, the short-term follow-up was less satisfactory for patients with scar-related VT. Pulsed electric field ablation was feasible with high acute efficacy, but the recurrences were common in the VT group, and acute non-inducibility may not be the optimal endpoint. Compared to radiofrequency energy, focal PF ablation within the great cardiac vein was not limited by high impedance or poor catheter-tip cooling and was not associated with coronary artery spasm. Unexpected conduction system block was observed during retrograde catheter ablation in the left ventricle due to current leakage from the proximal, shaft-visualizing electrodes of the ablation catheter. Myocardial lesion size was assessed by troponin levels, which increased from 19 ± 12 to 600 ± 425 ng/L (P < 0.001). The increase was higher in patients with VT compared to those with VPC, but the difference was not significant. The study concluded that focal PF ablation of VA demonstrated high acute efficacy in ablation of both VPC and scar-related VT, but the short-term success rate was more satisfactory in VPC patients. Pulsed electric field ablation was found particularly useful for ablation within the great cardiac vein. The study also highlighted the importance of safety, particularly in relation to coronary artery spasm and conduction system block. The study had limitations, including a small sample size and the inability to extrapolate findings to other PF ablation technologies.A prospective observational study evaluated the efficacy and safety of focal pulsed-field ablation (PF) for ventricular arrhythmias (VAs) in 44 patients (16 women, aged 61 ± 14 years) with either frequent ventricular premature complexes (VPCs, 48%) or scar-related ventricular tachycardia (VT, 52%). Ablation was performed using an irrigated 4 mm tip catheter and a commercially available PF generator. On average, 16 ± 15 PF applications (25 A) were delivered per patient. Acute success was achieved in 84% of patients, with 81% achieving elimination of VPC and 83% achieving non-inducibility of VT. At 3-month follow-up, 81% of patients with VPC had persistent suppression of VPC, and 52% of patients with scar-related VT remained free of any VA. However, the short-term follow-up was less satisfactory for patients with scar-related VT. Pulsed electric field ablation was feasible with high acute efficacy, but the recurrences were common in the VT group, and acute non-inducibility may not be the optimal endpoint. Compared to radiofrequency energy, focal PF ablation within the great cardiac vein was not limited by high impedance or poor catheter-tip cooling and was not associated with coronary artery spasm. Unexpected conduction system block was observed during retrograde catheter ablation in the left ventricle due to current leakage from the proximal, shaft-visualizing electrodes of the ablation catheter. Myocardial lesion size was assessed by troponin levels, which increased from 19 ± 12 to 600 ± 425 ng/L (P < 0.001). The increase was higher in patients with VT compared to those with VPC, but the difference was not significant. The study concluded that focal PF ablation of VA demonstrated high acute efficacy in ablation of both VPC and scar-related VT, but the short-term success rate was more satisfactory in VPC patients. Pulsed electric field ablation was found particularly useful for ablation within the great cardiac vein. The study also highlighted the importance of safety, particularly in relation to coronary artery spasm and conduction system block. The study had limitations, including a small sample size and the inability to extrapolate findings to other PF ablation technologies.