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Pulsed Field Ablation Index-Guided Ablation for Lesion Formation: Impact of Contact Force and Number of Applications in the Ventricular Model.
Di Biase, Luigi; Marazzato, Jacopo; Govari, Assaf; Altman, Andreas; Beeckler, Christopher; Keyes, Joe; Sharma, Tushar; Grupposo, Vito; Zou, Fengwei; Sugawara, Masafumi; Ikeda, Atsushi; Raissi, Farshad; Bhardwaj, Rahul; Hsu, Jonathan C; Lee, Mark; Banker, Rajesh; Mohanty, Sanghamitra; Natale, Andrea; Chen, Qi; Parikh, Paras; Zhang, Xiaodong; Nakagawa, Hiroshi.
Affiliation
  • Di Biase L; Department of Cardiology, Montefiore Medical Center, Bronx, NY (L.D.B., J.M., F.Z., X.Z.).
  • Marazzato J; Department of Cardiology, Montefiore Medical Center, Bronx, NY (L.D.B., J.M., F.Z., X.Z.).
  • Govari A; Electrophysiology and Cardiac Pacing Unit, Humanitas Mater Domini, Castellanza, Italy (J.M.).
  • Altman A; Biosense Webster, Irvine, CA (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Beeckler C; Biosense Webster, Yokne'am, Israel (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Keyes J; Biosense Webster, Irvine, CA (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Sharma T; Biosense Webster, Yokne'am, Israel (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Grupposo V; Biosense Webster, Irvine, CA (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Zou F; Biosense Webster, Yokne'am, Israel (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Sugawara M; Biosense Webster, Irvine, CA (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Ikeda A; Biosense Webster, Yokne'am, Israel (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Raissi F; Biosense Webster, Irvine, CA (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Bhardwaj R; Biosense Webster, Yokne'am, Israel (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Hsu JC; Biosense Webster, Irvine, CA (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Lee M; Biosense Webster, Yokne'am, Israel (A.G., A.A., C.B., J.K., T.S., V.G., Q.C., P.P.).
  • Banker R; Department of Cardiology, Montefiore Medical Center, Bronx, NY (L.D.B., J.M., F.Z., X.Z.).
  • Mohanty S; Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH (M.S., H.N.).
  • Natale A; Department of Cardiology, Nihon University of Medicine, Tokyo, Japan (A.I.).
  • Chen Q; University of California, San Diego, La Jolla (F.R., J.C.H.).
  • Parikh P; Loma Linda University Heart Institute, CA (R. Bhardwaj).
  • Zhang X; University of California, San Diego, La Jolla (F.R., J.C.H.).
  • Nakagawa H; Memorial Care Heart and Vascular Institute, Long Beach Medical Center, CA (M.L.).
Circ Arrhythm Electrophysiol ; 17(4): e012717, 2024 Apr.
Article in En | MEDLINE | ID: mdl-38390748
ABSTRACT

BACKGROUND:

The effect of contact force (CF) on lesion formation is not clear during pulsed field ablation (PFA). The aim of this study was to evaluate the impact of CF, PFA, and their interplay through the PFA index (PF index) formula on the ventricular lesion size in swine.

METHODS:

PFA was delivered through the CF-sensing OMNYPULSE catheter. Predefined PFA applications (×3, ×6, ×9, and ×12) were delivered maintaining low (5-25 g), high (26-50 g), and very high (51-80 g) CFs. First, PFA lesions were evaluated on necropsy in 11 swine to investigate the impact of CF/PFA-and their integration in the PF index equation-on lesion size (study characterization). Then, 3 different PF index thresholds-300, 450, and 600-were tested in 6 swine to appraise the PF index accuracy to predict the ventricular lesion depth (study validation).

RESULTS:

In the study characterization data set, 111 PFA lesions were analyzed. CF was 32±17 g. The average lesion depth and width were 3.5±1.2 and 12.0±3.5 mm, respectively. More than CF and PFA dose alone, it was their combined effect to impact lesion depth through an asymptotically increasing relationship. Likewise, not only was the PF index related to lesion depth in the study validation data set (r2=0.66; P<0.001) but it also provided a prediction accuracy of the observed depth of ±2 mm in 69/73 lesions (95%).

CONCLUSIONS:

CF and PFA applications play a key role in lesion formation during PFA. Further studies are required to evaluate the best PFA ablation settings to achieve transmural lesions.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Catheter Ablation Limits: Animals Language: En Journal: Circ Arrhythm Electrophysiol Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2024 Document type: Article
Fulltext
Add to My VHL
Print
XML
PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Catheter Ablation Limits: Animals Language: En Journal: Circ Arrhythm Electrophysiol Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2024 Document type: Article