Medtronic has introduced its “PulseSelect “pulsed field ablation system in India, bringing a newer approach to treating atrial fibrillation to the country’s cardiac care market.
Atrial fibrillation, commonly called AFib or AF, is an irregular heart rhythm that can increase the risk of stroke and heart failure. More than seven million people in India are estimated to have the condition, although diagnosis and treatment remain limited compared with the potential patient population. Among those seven million Indians was my own mother whose condition was not diagnosed in India; we discovered it on her first medical appointment when she returned to California at age 85. Today Apple watches claim to detect AFib.
PulseSelect uses a technology known as pulsed field ablation, or PFA. Cardiac ablation has long been used to treat certain patients with atrial fibrillation by disabling small areas of heart tissue responsible for abnormal electrical signals.
Traditional ablation systems generally accomplish this with either heat, known as radiofrequency ablation, or extreme cold, known as cryoablation. PFA takes a different approach, using very short electrical pulses to affect targeted cardiac cells without relying on thermal energy. Medtronic’s predecessor company Covidien, was a leader in these techniques from their Boulder, Colorado location. Medtronic already has a significant presence in the atrial fibrillation market through its cryoablation products. The addition of PulseSelect expands the range of technologies it can offer electrophysiologists treating patients with AFib.
The newer PFA technology has attracted considerable attention within cardiac electrophysiology because its effects can be more selective for cardiac tissue, potentially reducing unintended damage to nearby structures. For physicians, PFA provides another option alongside established ablation technologies rather than simply replacing them.
The India launch is significant because the country combines a large potential cardiac patient population with a healthcare system that is steadily adopting more sophisticated interventional technologies. Advanced cardiac procedures that were once concentrated in a relatively small number of major hospitals are increasingly available at specialized cardiac centers in India’s larger cities.
At the same time, the potential market should not be confused with the number of patients currently receiving advanced treatment. Atrial fibrillation can be difficult to detect because symptoms may be intermittent or relatively mild, and Medtronic itself notes that awareness, diagnosis and treatment rates in India remain low.
That creates challenges extending well beyond the availability of medical technology. Identifying patients, referring them to appropriate specialists and developing the electrophysiology infrastructure and trained clinical teams required to perform ablation procedures are all important parts of expanding treatment.
Medtronic’s India organization therefore sees PulseSelect as an additional treatment option rather than a solution to the broader problem of underdiagnosis. Chandrashekhar Jaiman, Senior Director for Cardiovascular and Electrophysiology Therapies at Medtronic India, acknowledged that technology alone cannot address the gaps in India’s AFib diagnosis and care pathways.
For Medtronic, the introduction is another expansion of its cardiovascular business in India and brings a technology already developed for other major markets into the country’s growing specialty-care sector.
Why This Matters
It also illustrates a broader change underway in India’s medical device market. As major hospital systems invest in more advanced cardiac, cancer and surgical capabilities, multinational device manufacturers are introducing sophisticated technologies in India closer to their international launches rather than treating the country primarily as a market for older or lower-cost products.
The size of India’s patient population makes that shift commercially important, but adoption of technologies such as PFA will ultimately depend on more than market potential. Hospital investment, physician training, reimbursement, patient diagnosis and clinical experience will determine how broadly these systems move beyond India’s leading cardiac centers.
