Convergence Watch: The Same Electric Pulse That Fixes AFib Is Coming for Brain Tumors

In an electrophysiology lab somewhere in the United States this morning, a cardiologist threaded a flower-shaped basket catheter through a femoral vein, parked it at the mouth of a pulmonary vein, and pressed a button. A square-wave electrical pulse, a few microseconds wide and a couple of thousand volts tall, ripped open the membranes of the heart-tissue cells in front of the electrode. The cells died. The nerves and blood vessels behind them did not. Total ablation time on the case: about thirty minutes. The patient was on the recovery couch before lunch.

That machine, Boston Scientific’s Farapulse, generated more than \$1 billion in revenue in its first full year on the U.S. market, according to the company’s own disclosures and reporting in Fierce Biotech. It received its initial FDA approval on January 31, 2024, for paroxysmal atrial fibrillation. The MANIFEST-17K registry has now logged real-world data on more than 17,000 patients. Cardiac Rhythm News reports it expanded to persistent AFib later in 2024.

This is the most lucrative new device category in cardiology in a decade. It is also a clue about something larger that almost nobody is reporting on, because the people who notice it are sitting in different conferences.

The same pulse generator that just rewrote cardiac ablation is being pointed at solid tumors. And at the blood-brain barrier. And at decellularized organ scaffolds for transplant. The cardiologists call it pulsed field ablation. The oncologists call it irreversible electroporation. They are the same physical phenomenon, discovered in 1972 in a paper that almost nobody outside biophysics ever read.

The 1972 paper that became a billion-dollar industry

In 1972 Eberhard Neumann and Kurt Rosenheck published “Permeability changes induced by electric impulses in vesicular membranes.” It is a small, technical paper about what happens to fatty bubbles when you zap them: the lipid bilayer transiently breaks down, opens nanometer-scale pores, and either reseals or doesn’t. Cited 689 times now in the OpenAlex literature graph, it sat largely unused for a generation.

Boris Rubinsky’s bioengineering lab at UC Berkeley dragged the phenomenon into surgery. In 2005, Rubinsky and his then-student Rafael Davalos co-authored “Tissue ablation with irreversible electroporation,” published in the Annals of Biomedical Engineering. They argued that if you tuned the pulses past the point of resealing, you could kill cells without heat — preserving collagen scaffolds, nerves, and blood vessels that thermal ablation, microwave, and cryotherapy all wreck. By 2007 the Berkeley group was publishing on prostate ablation and the strange way IRE leaves blood vessels intact. By 2010 the first paper on intracranial use had appeared.

AngioDynamics commercialized that early Berkeley work as the NanoKnife, a refrigerator-sized box that pushes microsecond pulses out of needle electrodes. It ran up against the same problem every IRE clinician hit: the pulses are so violent that the patient’s whole muscle group spasms, and the procedure requires general anesthesia and full neuromuscular blockade.

Davalos solved that problem after he moved to Virginia Tech. In 2011 he published high-frequency irreversible electroporation, or H-FIRE, in PLoS ONE. The trick: instead of one long unipolar pulse, deliver a tight burst of biphasic pulses, each only microseconds wide, alternating polarity inside the burst. The membranes still pop. The motor nerves don’t fire. No general anesthesia required.

Read his Virginia Tech patent US11254926 and the engineering is right there in the claims: “1 to 10,000 electrical pulses of 1 mV to 5,000 volts,” frequency between 1 Hz and 100 MHz, “a first polarity portion and a second polarity portion, each portion having a square waveform, a pulse width of at least 10 ns to 1 millisecond, and an intra-pulse instant charge reversal.” That is H-FIRE, written in patent language.

That patent family is what makes Farapulse possible. It is also what makes the rest of the body possible.

A state engineering school is the third-largest patent holder

Pull every U.S. utility grant since January 1, 2020, whose text mentions pulsed field ablation or irreversible electroporation, and group the assignees. The leaderboard is unexpected:

Each company’s count combines variant spellings and acquired subsidiaries. The number that should grab you is the third row. Virginia Tech, a public engineering school in Blacksburg, holds more issued U.S. patents in this technology since 2020 than Johnson & Johnson and AngioDynamics combined. It is the only non-corporate name in the top five. Its filings have actually accelerated: six grants in 2024.

Now look at what each assignee is patenting. Boston Scientific and Medtronic skew cardiac, with claim language about pulmonary vein isolation, basket catheters, and atrial fibrillation. Virginia Tech does not have a single cardiac-titled grant since 2020. Its filings, by contrast, are about brain tumor ablation under MRI guidance with shielded electrodes; about delivering IRE through the vasculature to decellularize organs into transplant scaffolds; about combining electroporation with checkpoint inhibitors; and about transiently opening the blood-brain barrier so chemotherapy can cross it.

That last one is worth lingering on. Virginia Tech’s US12059197, granted in August 2024, claims a method that uses non-thermal IRE to ablate brain tumors while keeping electrode tips cool enough to avoid thermal damage. US10959772, granted in 2021, covers using electrical energy to crack open the blood-brain barrier itself — a 60-year-old problem in oncology that nobody has solved with drugs. If the cardiac PFA market is the one Boston Scientific is winning, the brain market is the one Virginia Tech has spent fifteen years patenting.

What just happened in December 2024

The signal that the next wave has started is the FDA’s quiet 510(k) clearance of AngioDynamics’ NanoKnife system for prostate tissue ablation in December 2024, on the back of the PRESERVE study published in European Urology. PRESERVE enrolled 121 men with intermediate-risk prostate cancer across 17 sites. At 12 months, 71 percent had a negative in-field biopsy and 95 percent had reduced PSA. Most adverse events were mild.

That clearance is the same generator architecture as Farapulse, pointed at a different organ. The cardiology shop and the urology shop are now running on what is, electrically, the same machine.

Why an R\&D director should care

Three things follow from this.

First, the cost of being late to PFA in cardiac is now fully known. Johnson & Johnson and Abbott are paying it. The cost of being late to PFA in oncology is not yet known, because the indications are still being approved one organ at a time. The companies that own the relevant claims are not all the same companies.

Second, the engineering is converging hard. A waveform that is safe and effective in the left atrium is also a workable starting point for the prostate, the liver, and increasingly the brain, provided you tune the pulse train. That means the supplier base, the contract manufacturers building disposable electrode arrays, and the ASIC houses making high-voltage pulse generators are all selling into a market that is bigger than any single specialty would suggest.

Third, the licensing geometry around Virginia Tech is now an unusually concentrated piece of strategic real estate. Davalos has co-founded several startups out of his lab — Roanoke Times and Virginia Tech’s own innovation office have profiled VoltMed among them — but the bulk of the IP estate sits with the university’s licensing arm. For a strategic acquirer, the choice is whether to license VT’s H-FIRE and brain claims early, or wait for the next FDA approval cycle and discover the price has moved.

Boston Scientific spent \$295 million to acquire the remaining 73 percent of Farapulse in 2021, plus up to \$125 million in milestones, MedTech Dive reported. Three years later that asset crossed a billion dollars in annual revenue. The 1972 Neumann paper has been waiting in the literature the whole time. The next ten patents from Virginia Tech are not.

Method. Patent counts are from a corpus of 9.3 million U.S. utility grants, sourced from USPTO bulk grant XML, queried for the phrases “pulsed field ablation” or “irreversible electroporation” in title, abstract, claims, or description. The window is January 2020 through late September 2025 — the most recent month for which weekly grant feeds are fully indexed. Each company’s count combines variant spellings and acquired subsidiaries: Farapulse rolls into Boston Scientific, Covidien and Ablation Frontiers roll into Medtronic, Biosense Webster sits under J\&J. Foundational paper history was traced through OpenAlex (357 million scientific works), with citation counts as of May 2026. Patent claim language is quoted from the United States Patent and Trademark Office grant text. Market size figures and FDA approval dates were verified against company press releases and the trade publications named inline.