Impact of Contact Force on Pulsed Field Ablation Outcomes Using Focal Point Catheter.
Circ Arrhythm Electrophysiol
; 17(6): e012723, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38690671
ABSTRACT
BACKGROUND:
Conventional focal radiofrequency catheters may be modified to enable multiple energy modalities (radiofrequency or pulsed field [PF]) with the benefit of contact force (CF) feedback, providing greater flexibility in the treatment of arrhythmias. Information on the impact of CF on lesion formation in PF ablations remains limited.METHODS:
An in vivo study was performed with 8 swine using an investigational dual-energy CF focal catheter with local impedance. Experiment I To evaluate atrial lesion formation, contiguity, and width, a point-by-point approach was used to create an intercaval line. The distance between the points was prespecified at 4±1 mm. Half of the line was created with radiofrequency energy, whereas the other half utilized PF (single 2.0 kV application with a proprietary waveform). Experiment II To evaluate single application lesion dimensions with a proprietary waveform, discrete ventricular lesions were performed with PFA (single 2.0 kV application) with targeted levels of CF low, 5 to 15 g; medium, 20 to 30 g; and high, 35 to 45 g. Following 1 week of survival, animals underwent endocardial/epicardial remapping, and euthanasia to enable histopathologic examination.RESULTS:
Experiment I Both energy modalities resulted in a complete intercaval line of transmural ablation. PF resulted in significantly wider lines than radiofrequency minimum width, 14.9±2.3 versus 5.0±1.6 mm; maximum width, 21.8±3.4 versus 7.3±2.1 mm, respectively; P<0.01 for each. Histology confirmed transmural lesions with both modalities. Experiment II With PF, lesion depth, width, and volume were larger with higher degrees of CF (depth r=0.82, P<0.001; width r=0.26, P=0.052; and volume r=0.55, P<0.001), with depth increasing at a faster rate than width. The mean depths were as follows low (n=17), 4.3±1.0 mm; medium (n=26), 6.4±1.2 mm; and high (n=14), 9.1±1.4 mm.CONCLUSIONS:
Using the same focal point CF-sensing catheter, a novel PF ablation waveform with a single application resulted in transmural atrial lesions that were significantly wider than radiofrequency. Lesion depth showed a significant positive correlation with CF with depths of 6.4 mm at moderate CF.Palavras-chave
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ablação por Cateter
/
Desenho de Equipamento
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Cateteres Cardíacos
Limite:
Animals
Idioma:
En
Revista:
Circ Arrhythm Electrophysiol
Ano de publicação:
2024
Tipo de documento:
Article