Details

Autor(en) / Beteiligte

• Doshi, Shephal K.
• Flaherty, Mary Clare
• Laughner, Jacob
• Quan, Melinda
• Anic, Ante

Titel

Catheter–tissue contact optimizes pulsed electric field ablation with a large area focal catheter

Ist Teil von

• Journal of cardiovascular electrophysiology, 2024-04, Vol.35 (4), p.765-774

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2024

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• 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. Pulsed electric field (PEF) ablation with a specialized large area focal catheter in a swine model is dependent on catheter–tissue contact. Local impedance can be used as an indicator of catheter–tissue contact and aid in the creation of consistent transmural lesions in PEF ablation.