What is the clinical evidence from this study?

Study design: Other. Intervention: Single biphasic electroporation pulses (Pulsed field ablation). Primary outcome: Stimulation thresholds, conduction suppression, and recovery.

What does this research mean for the field?

Single pulsed field ablation pulses induce parameter-dependent nerve excitation and reversible conduction suppression in isolated porcine phrenic and vagus nerves, with recovery exceeding 80% within 30 minutes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To characterize the influence of electroporation pulse parameters on the activation, conduction block, and functional recovery of isolated phrenic and vagus nerves.

September 20, 2026Heart Rhythm

Single PFA pulses induce reversible conduction suppression in porcine nerves with >80% recovery.

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Why the study?

Do single biphasic electroporation pulses induce excitation and conduction suppression in ex vivo swine phrenic and vagus nerves?

Population

Ex vivo swine phrenic and vagus nerves

Design

Preclinical

Follow-up

30 minutes

Key result

Single pulsed field ablation pulses induced parameter-dependent nerve excitation and reversible conduction suppression in isolated porcine nerves, with >80% recovery within 30 minutes.

Authors

MRMatej Reberšek WUWeston Upchurch RŠRok Šmerc

Discussion

Member takes

Overview

Pulse parameters warrant optimization to limit phrenic/vagus effects during PFA; leaves open clinical translation and safety thresholds.

Key Points

To characterize the influence of electroporation pulse parameters on the activation, conduction block, and functional recovery of isolated phrenic and vagus nerves.
Mounted ex vivo swine phrenic and vagus nerves in a multi-electrode chamber to record four-channel compound action potentials across varying pulse amplitudes, pulse widths (0.5–10 μs), and interphase delays (0.5–1000 μs).
Constructed a computational in silico model of the phrenic nerve to evaluate electric field distribution and perineurium field exposure.
Stimulation thresholds increased as pulse width and interphase delay decreased, with unmyelinated fibers requiring 6.8- to 8.3-fold higher voltages for activation than myelinated fibers.
Conduction suppression intensified with higher pulse amplitudes and longer pulse widths, producing complete but reversible conduction block that recovered to over 80% of baseline compound action potential amplitude within 30 minutes.
In silico modeling revealed steep electric field gradients near stimulating electrodes and concentrated field magnitudes within the perineurium.

Structured PICO

Do single biphasic electroporation pulses induce excitation and conduction suppression in ex vivo swine phrenic and vagus nerves?

Population

Ex vivo swine phrenic and vagus nerves exposed to single biphasic electroporation pulses to assess neural effects.

Intervention

Single biphasic electroporation pulses with varying pulse amplitude, pulse width (0.5-10 μs), and interphase delay (0.5-1000 μs)

Outcome

Stimulation thresholds, conduction suppression, and recovery over timesurrogate

Single pulsed field ablation pulses induce parameter-dependent excitation and reversible conduction suppression in isolated porcine nerves, providing mechanistic insight into PFA-related off-target neural effects.

Limitations

Quantitative translation will require clinically representative catheter geometries and complete pulse trains.

Cite This Study

Reberšek et al. (2026) studied this question. Single biphasic electroporation pulses (Pulsed field ablation) was evaluated on Stimulation thresholds, conduction suppression, and recovery. Single pulsed field ablation pulses induced parameter-dependent nerve excitation and reversible conduction suppression in isolated porcine nerves, with >80% recovery within 30 minutes.

synapsesocial.com/papers/6aaf996513be617d9320fee3 https://doi.org/10.1016/j.hrthm.2026.09.023

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September 20, 2026Heart Rhythm

Single PFA pulses induce reversible conduction suppression in porcine nerves with >80% recovery.

View Full Paper

Ask AI

Bookmark

Why the study?

Do single biphasic electroporation pulses induce excitation and conduction suppression in ex vivo swine phrenic and vagus nerves?

Population

Ex vivo swine phrenic and vagus nerves

Design

Preclinical

Follow-up

30 minutes

Key result

Single pulsed field ablation pulses induced parameter-dependent nerve excitation and reversible conduction suppression in isolated porcine nerves, with >80% recovery within 30 minutes.

Authors

MRMatej Reberšek WUWeston Upchurch RŠRok Šmerc

Discussion

Member takes

Overview

Pulse parameters warrant optimization to limit phrenic/vagus effects during PFA; leaves open clinical translation and safety thresholds.

Key Points

To characterize the influence of electroporation pulse parameters on the activation, conduction block, and functional recovery of isolated phrenic and vagus nerves.
Mounted ex vivo swine phrenic and vagus nerves in a multi-electrode chamber to record four-channel compound action potentials across varying pulse amplitudes, pulse widths (0.5–10 μs), and interphase delays (0.5–1000 μs).
Constructed a computational in silico model of the phrenic nerve to evaluate electric field distribution and perineurium field exposure.
Stimulation thresholds increased as pulse width and interphase delay decreased, with unmyelinated fibers requiring 6.8- to 8.3-fold higher voltages for activation than myelinated fibers.
Conduction suppression intensified with higher pulse amplitudes and longer pulse widths, producing complete but reversible conduction block that recovered to over 80% of baseline compound action potential amplitude within 30 minutes.
In silico modeling revealed steep electric field gradients near stimulating electrodes and concentrated field magnitudes within the perineurium.

Structured PICO

Do single biphasic electroporation pulses induce excitation and conduction suppression in ex vivo swine phrenic and vagus nerves?

Population

Ex vivo swine phrenic and vagus nerves exposed to single biphasic electroporation pulses to assess neural effects.

Intervention

Single biphasic electroporation pulses with varying pulse amplitude, pulse width (0.5-10 μs), and interphase delay (0.5-1000 μs)

Outcome

Stimulation thresholds, conduction suppression, and recovery over timesurrogate

Limitations

Quantitative translation will require clinically representative catheter geometries and complete pulse trains.

Cite This Study

synapsesocial.com/papers/6aaf996513be617d9320fee3 https://doi.org/10.1016/j.hrthm.2026.09.023

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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