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Application repetition and electrode-tissue contact result in deeper lesions using a pulsed-field ablation circular variable loop catheter.
Di Biase, Luigi; Marazzato, Jacopo; Gomez, Tara; Byun, Eric; Zou, Fengwei; Grupposo, Vito; Mohanty, Sanghamitra; La Fazia, Vincenzo Mirco; Ammirati, Giuseppe; Lin, Aung; Garcia, Domingo Ynoa; Della Rocca, Domenico; Al Ahamad, Amin; Schiavone, Marco; Gasperetti, Alessio; Freilich, Michael; Serna, Juan Cedeno; Forleo, Giovanni; Liu, Xu; Lakkireddy, Dhanunjaya; Tondo, Claudio; Natale, Andrea; Zhang, Xiao-Dong.
Afiliación
  • Di Biase L; Department of Cardiology, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA.
  • Marazzato J; Department of Cardiology, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA.
  • Gomez T; Electrophysiology and Cardiac Pacing Unit, Humanitas Mater Domini, Castellanza, Italy.
  • Byun E; Biosense Webster Inc., Irvine, CA, USA.
  • Zou F; Biosense Webster Inc., Irvine, CA, USA.
  • Grupposo V; Department of Cardiology, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA.
  • Mohanty S; Biosense Webster Inc., Irvine, CA, USA.
  • La Fazia VM; Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA.
  • Ammirati G; Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA.
  • Lin A; Department of Cardiology, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA.
  • Garcia DY; Department of Cardiology, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA.
  • Della Rocca D; Department of Cardiology, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA.
  • Al Ahamad A; Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA.
  • Schiavone M; Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA.
  • Gasperetti A; Centro Cardiologico Monzino, Milan, Italy.
  • Freilich M; Department of Cardiology, Johns Hopkins Hospital, Baltimore, MD, USA.
  • Serna JC; Department of Cardiology, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA.
  • Forleo G; Department of Cardiology, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA.
  • Liu X; Department of Cardiology, Luigi Sacco Hospital, Milan, Italy.
  • Lakkireddy D; Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
  • Tondo C; Kansas City Heart Rhythm Institute, Overland Park, KS, USA.
  • Natale A; Centro Cardiologico Monzino, Milan, Italy.
  • Zhang XD; Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA.
Europace ; 26(9)2024 Aug 30.
Article en En | MEDLINE | ID: mdl-39150065
ABSTRACT

AIMS:

Pulsed-field ablation (PFA) is a novel, myocardial-selective, non-thermal ablation modality used to target cardiac arrhythmias. Although prompt electrogram (EGM) signal disappearance is observed immediately after PFA application in the pulmonary veins, whether this finding results in adequate transmural lesions is unknown. The aim of this study is to check whether application repetition and catheter-tissue contact impact lesion formation during PFA. METHODS AND

RESULTS:

A circular loop PFA catheter was used to deliver repeated energy applications with various levels of contact force. A benchtop vegetal potato model and a beating heart ventricular myocardial model were utilized to evaluate the impact of application repetition, contact force, and catheter repositioning on contiguity and lesion depth. Lesion development occurred over 18 h in the vegetal model and over 6 h in the porcine model. Lesion formation was found to be dependent on application repetition and contact. In porcine ventricles, single and multiple stacked applications led to a lesion depth of 3.5 ± 0.7 and 4.4 ± 1.3 mm, respectively (P = 0.002). Furthermore, the greater the catheter-tissue contact, the more contiguous and deeper the lesions in the vegetal model (1.0 ± 0.9 mm with no contact vs. 5.4 ± 1.4 mm with 30 g of force; P = 0.0001).

CONCLUSION:

Pulsed-field ablation delivered via a circular catheter showed that both repetition and catheter contact led independently to deeper lesion formation. These findings indicate that endpoints for effective PFA are related more to PFA biophysics than to mere EGM attenuation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ablación por Catéter / Diseño de Equipo / Catéteres Cardíacos Límite: Animals Idioma: En Revista: Europace Asunto de la revista: CARDIOLOGIA / FISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ablación por Catéter / Diseño de Equipo / Catéteres Cardíacos Límite: Animals Idioma: En Revista: Europace Asunto de la revista: CARDIOLOGIA / FISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido