A 4 mm non-irrigated solid-tip catheter significantly increased the depth, diameter, and volume of irreversible electroporation lesions compared to an open-irrigated flexible-tip catheter.
Does a solid-tip 4 mm non-irrigated catheter increase lesion dimensions compared to an open-irrigated flexible-tip catheter during focal-bipolar pulsed field ablation in an in vitro potato model?
In an in vitro potato model, a solid-tip 4 mm non-irrigated catheter created significantly larger and deeper lesions during focal-bipolar pulsed field ablation compared to an open-irrigated flexible-tip catheter.
Effect estimate: Mean difference 0.3 (95% CI 0.01-0.55)
Absolute Event Rate: 1.7% vs 1.4%
p-value: p=0.03
Pulsed field ablation (PFA) is a novel technique for pulmonary vein isolation (PVI) in the treatment of atrial fibrillation (AF). However, the impact of electrode type on lesion formation at fixed PFA parameters remains unknown. This study investigated differences in lesion characteristics when using a 4 mm non-irrigated catheter versus an open-irrigated flexible-tip catheter in focal-bipolar PFA in a potato model. PFA applications were performed in a potato model using a purpose-made PFA generator, applying both a solid-tip 4 mm non-irrigated catheter and an open-irrigated flexible-tip catheter under identical energy delivery parameters. After electroporation, potatoes were stained with triphenyltetrazolium chloride (TTC) to visualize lesion boundaries. Depth, diameter, and volume of the irreversibly electroporated zones were measured to assess the impact of each electrode type. A total of fifty PFA applications were performed − 25 with the 4 mm non-irrigated catheter and 25 with the open-irrigated flexible-tip catheter. The depth of the irreversible electroporation zone was significantly greater with the 4 mm non-irrigated catheter than with the irrigated electrode (1.7 ± 0.5 mm vs. 1.4 ± 0.7 mm, p = 0.03). The diameter of irreversible lesions created with the 4 mm electrode was 7 ± 1 mm, compared to 6 ± 1 mm with the irrigated electrode (p = 0.001), resulting in a total lesion volume of 46 ± 19 mm³ versus 30 ± 12 mm³, respectively (p = 0.0008). The use of a solid-tip 4 mm non-irrigated catheter in focal-bipolar PFA creates lesions with greater depth, volume and diameter compared to an open-irrigated flexible-tip catheter. Ablation catheter type significantly influences lesion spread during focal-bipolar PFA.
Zarębski et al. (Fri,) conducted a other in In vitro electroporation (potato model) (n=50). 4 mm non-irrigated solid-tip catheter vs. Open-irrigated flexible-tip catheter was evaluated on Depth of irreversible electroporation zone (mm) (Mean difference 0.3, 95% CI 0.01-0.55, p=0.03). A 4 mm non-irrigated solid-tip catheter significantly increased the depth, diameter, and volume of irreversible electroporation lesions compared to an open-irrigated flexible-tip catheter.