Opportunities and Challenges in Catheter-Based Irreversible Electroporation for Ventricular Tachycardia

Round 1

Reviewer 1 Report

The authors have presented a comprehensive review summarising the pathophysiological mechanisms underlying VT, and then summarize the preclinical and clinical data published to-date on the effectiveness of pulsed field ablation to treat monomorphic VT. These review compares PFA with the effectiveness ascribed to thermal cardiac ablation modalities to treat VT.

The authors should be congratulated on this review article which provides a detailed compilation of the available studies in the field to date. The article is well written and the flow of the review article is justified. The appropriate references have been cited and appropriate conclusions drawn from the cited articles.

The quality of English used in good and I have no concerns.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

The subject treated by the authors in this review is of high clinical interest.

1. The first part concerning VTs aetiology and mechanisms is very well described and summarised. It would be interesting to have schemes or patterns of VT mechanisms (reentry) for better comprehension 

2. The part concerning pulsed field ablation (PFA) requires more information and developments:

- schemes on the mechanisms of PFA on cells

- the part of PFA on VTs regarding the case reports published should be analyzed in details and discussed; indeed it is the main part of the paper;

- a table about the cases published should be welcomed

- the paper of Adragao et al. concerning ventricle lesions of PFA is also subject of discussion (patient requiring transplantation, etc...)

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

No further comments