Pulsed Field Ablation Therapy Parameters: Enhancing Lesion Depth While Reducing Musculoskeletal Stimulation and Thermal Response in an Irrigated Tip Catheter: A Comprehensive Study Using In Silico, In Vitro, and In Vivo Models

Figures

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  Figure 1.. Histogram of lesion depth according to burst count. Increasing burst count increases the distribution of lesion depths. StDev indicates SD.

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  Figure 2.. Contour plot of predicted depth with varying levels of pulses per burst and pulse width with 5 bursts. As pulse width or pulses per burst are increased, so too is lesion depth.

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  Figure 3.. Contour plot of predicted acceleration (Accel) with varying levels of pulses per burst and pulse width. As pulse width or pulses per burst are increased, so too is musculoskeletal stimulation. DOE indicates design of experiments.

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  Figure 4.. The in vivo lesion depths obtained for 4 candidate therapies on a single therapy application in a canine model. Candidate therapies are created by balancing lesion depth with undesired musculoskeletal stimulation.

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  Figure 5.. Thermal profile of therapy A (150 ppb) vs therapy D (250 ppb) at various irrigation rates, when 4 therapy applications of each therapy were performed. A through D, Temperature at the tissue surface measured from the proximal electrode (A), distal electrode (B), and then temperatures measured at 3 mm (C) and 7 mm (D) below the tissue surface. E, Summarizes incidence of temperature >50 C for therapy D at various irrigation rates, and (F) summarizes the incidence of temperature >50 C for therapy A at various irrigation rates. Tpeak indicates peak temperature; and Tsurf, temperature at the surface.

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  Figure 6.. Thermal damage probability across various irrigation levels. The higher the probability (y axis), the greater the likelihood of thermal damage.

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  Figure 7.. Analysis was performed using the Arrhenius equation (equation 2) to evaluate the likelihood of thermal damage on tissues subjected to 4 consecutive therapy applications. As irrigation rate increases, the maximum temperature generated by the pulsed field catheter decreases. Max Temp refers to maximum temperature.