A multielectrode spherical array catheter achieved durable pulmonary vein isolation and transmural lesions using both pulsed field and radiofrequency ablation with excellent safety in animal models.
Does microsecond pulsed field ablation using a spherical array catheter achieve comparable efficacy and safety to radiofrequency ablation for pulmonary vein isolation in a preclinical model?
A novel spherical array catheter can safely and effectively achieve circumferential, linear, and focal ablation using both pulsed field and radiofrequency energy in a preclinical model.
BACKGROUND: A multielectrode spherical array catheter capable of single-shot mapping and ablation has been introduced. OBJECTIVES: This study sought to compare the efficacy and safety of circumferential, linear, and focal ablation using either microsecond pulsed field (PF) and radiofrequency (RF) ablation in preclinical model. METHODS: Under general anesthesia, a 122 gold-plated multielectrode array was introduced into the left atrium. Twenty-nine canines underwent isolation of two pulmonary veins (PVs), with linear and focal left atrial ablation with both RF (n = 12) and PF (n = 17). PF was also delivered within the superior vena cava and atop the esophagus in three swine. Animals were sacrificed acutely (immediately for RF 6 of 12 and 3 days for PF 6 of 17) and the remaining (n = 17) at 14 to 30 days. Detailed necropsy and histopathology were performed. RESULTS: All PVs were acutely (58 of 58) and durably (34 of 34) isolated and exhibited wide confluent lesions. Lesions were transmural for 97% to 100% of sections with depths of 2.5 to 3.4 mm and 2.5 to 3.5 mm in the acute and chronic cohorts, respectively. Linear and focal lesions displayed transmurality rates of 85% to 100% with depths of 3.5 millimeters to 4.2 millimeters in the acute cohort. In the chronic cohorts, linear lesions created with RF, PF+RF, and PF had no significant differences in depth (3.5 ± 1.8 mm, 4.0 ± 1.4 mm, and 3.9 ± 0.9 mm) or transmurality (83.3%, 100%, and 80%). Current of injury was seen on local unipolar electrogram immediately after PF and RF, and this occurred to a wider extent with PF. PF but not RF elicited bradycardia from ganglionated plexi stimulation. There were no instances of phrenic palsy, venous stenosis, esophageal damage, or thromboembolism. CONCLUSIONS: Circumferential, linear, and focal mapping and ablation can be achieved with this novel catheter using both PF and RF, with excellent efficacy and safety.
Koruth et al. (Fri,) conducted a other in Preclinical model for pulmonary vein isolation (n=32). Pulsed field ablation using a multielectrode spherical array catheter vs. Radiofrequency ablation was evaluated on Efficacy and safety of circumferential, linear, and focal ablation. A multielectrode spherical array catheter achieved durable pulmonary vein isolation and transmural lesions using both pulsed field and radiofrequency ablation with excellent safety in animal models.