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Point-by-Point Pulsed Field Ablation Using a Multimodality Generator and a Contact Force-Sensing Ablation Catheter: Comparison With Radiofrequency Ablation in a Remapped Chronic Swine Heart.
Di Biase, Luigi; Marazzato, Jacopo; Zou, Fengwei; Lin, Aung; Grupposo, Vito; Chowdhuri, Nilarun; Maffre, Jennifer; Farshchi-Heydari, Salman; Sharma, Tushar; Beeckler, Christopher; Govari, Assaf; Bhardwaj, Rahul; Mohanty, Sanghamitra; Natale, Andrea; Nakagawa, Hiroshi; Zhang, Xiaodong.
Afiliación
  • Di Biase L; Division of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).
  • Marazzato J; Division of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).
  • Zou F; Division of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).
  • Lin A; Division of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).
  • Grupposo V; Biosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
  • Chowdhuri N; Division of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).
  • Maffre J; Biosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
  • Farshchi-Heydari S; Biosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
  • Sharma T; Biosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
  • Beeckler C; Biosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
  • Govari A; Biosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
  • Bhardwaj R; Loma Linda University Medical Center (R.B.).
  • Mohanty S; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (S.M., A.N.).
  • Natale A; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (S.M., A.N.).
  • Nakagawa H; Section of Cardiac Electrophysiology & Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (H.N.).
  • Zhang X; Division of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).
Circ Arrhythm Electrophysiol ; 16(12): 663-671, 2023 12.
Article en En | MEDLINE | ID: mdl-37994554
BACKGROUND: Pulsed field ablation (PFA) has emerged as an alternative to radiofrequency ablation. However, data on focal point-by-point PFA are scarce. The aim of this study was to compare lesion durability and collateral damage between focally delivered unipolar/biphasic PFA versus radiofrequency in swine. METHODS: Eighteen swine were randomized to low-dose PFA, high-dose PFA, and radiofrequency using a multimodality generator. Radiofrequency delivered by market-available generator served as control group. A contact force-sensing catheter was used to focally deliver PFA/radiofrequency at the pulmonary veins and other predefined sites in the atria. Animals were remapped postprocedurally and 28 days postablation to test lesion durability followed by gross necroscopy and histology. RESULTS: All targeted sites were successfully ablated (contact force value, 13.9±4.1 g). Follow-up remapping showed persistent pulmonary vein isolation in all animals (100%) with lesion durability at nonpulmonary vein sites proven in most (98%). Regardless of the energy source used, the lesion size was similar across the study groups. Transmurality was achieved in 95% of targeted sites and 100% at pulmonary veins. On histology, PFA animals showed more mature scar formation than their radiofrequency counterpart without myocardial necrosis or inflammation. Finally, no sign of collateral damage was observed in any of the groups. CONCLUSIONS: In a randomized preclinical study, focally delivered unipolar/biphasic PFA guided by contact force values was associated with durable lesions on chronic remapping and with mature scar formation on histology without signs of collateral injury on necroscopy. Further studies are needed to investigate the long-term feasibility of this new approach to atrial fibrillation treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Venas Pulmonares / Fibrilación Atrial / Ablación por Catéter / Ablación por Radiofrecuencia Límite: Animals Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Venas Pulmonares / Fibrilación Atrial / Ablación por Catéter / Ablación por Radiofrecuencia Límite: Animals Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos