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JACC Clin Electrophysiol ; 9(9): 1854-1863, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37480857

RESUMO

BACKGROUND: Pulsed electrical field (PEF) ablation may cause tissue heating. These changes are reportedly small, but each PEF system and waveform will have a different behavior, and data are lacking. OBJECTIVES: This study sought to compare the temperature profile of focal point, monopolar biphasic PEF ablation versus radiofrequency (RF). METHODS: Ablation lesions were performed on perfused thigh muscle of swine. PEF lesions were performed with 3 compatible ablation catheters at the highest (25 amp) energy, and 1 catheter (Tacticath SE) was also used at the 22- and 19-amp levels. Temperature changes in the tissue were measured using fluoroptic temperature probes inserted at the muscle surface, as well as 3 mm and 7 mm below the surface. Temperatures were recorded continuously at baseline, during delivery, and after ablation. Muscle temperatures were compared with those of RF lesions performed with 1 catheter (Tacticath SE) at 30 W for 30 seconds. RESULTS: PEF ablation with 3energy settings produced small temperature changes. Maximum average temperature rise for PEF for the maximum (25-amp) energy setting (32 lesions) was 7.6 °C, 2.8 °C, and 0.9 °C at the surface, 3-mm depth, and 7-mm depth, respectively. The temperature rise was dose dependent, with lower energy settings yielding less temperature rise. RF ablations (10 lesions) produced temperature increases of 16.6 °C, 39.8 °C, and 9.5 °C at the surface, 3-mm depth, and 7-mm depth, respectively. CONCLUSIONS: PEF caused detectable temperature changes in muscle tissue, which never exceeded 2.8 °C at the 3-mm depth versus baseline. By contrast, RF produced substantial temperature rises. These data support that focal monopolar biphasic energy delivered by this PEF technology retains a favorable thermal safety profile.


Assuntos
Ablação por Cateter , Animais , Suínos , Catéteres , Eletricidade , Terapia de Eletroporação Irreversível , Temperatura
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