Catheter-tissue contact optimizes pulsed electric field ablation with a large area focal catheter.
J Cardiovasc Electrophysiol
; 35(4): 765-774, 2024 Apr.
Article
em En
| MEDLINE
| ID: mdl-38357859
ABSTRACT
INTRODUCTION:
Pulsed electric field (PEF) ablation relies on the intersection of a critical voltage gradient with tissue to cause cell death. Field-based lesion formation with PEF technologies may still depend on catheter-tissue contact (CTC). The purpose of this study was to assess the impact of CTC on PEF lesion formation with an investigational large area focal (LAF) catheter in a preclinical model.METHODS:
PEF ablation via a 10-spline LAF catheter was used to create discrete right ventricle (RV) lesions and atrial lesion sets in 10 swine (eight acute, two chronic). Local impedance (LI) was used to assess CTC. Lesions were assigned to three cohorts using LI above baseline no tissue contact (NTC ≤∆10 Ω, close proximity to tissue), low tissue contact (LTC ∆11-29 Ω), and high tissue contact (HTC ≥∆30 Ω). Acute animals were infused with triphenyl tetrazolium chloride (TTC) and killed ≥2 h post-treatment. Chronic animals were remapped 30 days post-index procedure and stained with infused TTC.RESULTS:
Mean (± SD) RV treatment sizes between LTC (n = 14) and HTC (n = 17) lesions were not significantly different (depth 5.65 ± 1.96 vs. 5.68 ± 2.05 mm, p = .999; width 15.68 ± 5.22 vs. 16.98 ± 4.45 mm, p = .737), while mean treatment size for NTC lesions (n = 6) was significantly smaller (1.67 ± 1.16 mm depth, 5.97 ± 4.48 mm width, p < .05). For atrial lesion sets, acute and chronic conduction block were achieved with both LTC (N = 7) and HTC (N = 6), and NTC resulted in gaps.CONCLUSIONS:
PEF ablation with a specialized LAF catheter in a swine model is dependent on CTC. LI as an indicator of CTC may aid in the creation of consistent transmural lesions in PEF ablation.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Ablação por Cateter
Limite:
Animals
/
Humans
Idioma:
En
Revista:
J Cardiovasc Electrophysiol
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos