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Pulsed-Field Ablation Using a Novel Ablation-Mapping Integrated System for Pulmonary Vein Isolation—A Preliminary Animal Study

Objective: The purpose of this study is to evaluate the preliminary safety and effect of a pulsed electric field (PEF) ablation system. Methods: The pulmonary veins (PVs) and superior vena cava (SVC) were isolated with the pulsed field ablation (PFA) system, which included a PEF generator and an ele...

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Detalles Bibliográficos
Autores principales: Zhao, Zhihong, Chen, Yonggang, Wu, Bin, Qiu, Gaodong, Hong, Liangjie, Chen, Xinhua, Zhang, Xingwei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781645/
https://www.ncbi.nlm.nih.gov/pubmed/36547422
http://dx.doi.org/10.3390/jcdd9120425
Descripción
Sumario:Objective: The purpose of this study is to evaluate the preliminary safety and effect of a pulsed electric field (PEF) ablation system. Methods: The pulmonary veins (PVs) and superior vena cava (SVC) were isolated with the pulsed field ablation (PFA) system, which included a PEF generator and an electrode. The effects of PFA were investigated in six porcines using a novel circular catheter with combined functions (mapping/ablation) designed to work with a cardiac mapping system. The PEF generator delivered a train of biphasic pulsed electric pulses with a high amplitude (800–2000 V) and short pulse duration. The voltage mapping, PVs and SVC potentials, ostial diameters, and phrenic nerve and esophagus viability data were collected 4 weeks later, after which the animals were subsequently euthanized for gross histopathology analysis. Results: PFA 100% isolated the PVs and SVC with four applications with a mean pulse number of 100–150 pulses, causing no muscle convulsion. PFA does not cause PV stenosis or phrenic nerve dysfunction. Histological analysis confirmed 100% transmurally without any venous stenoses or phrenic injuries. Pathology follow-up showed that PFA had selectively ablated cardiomyocytes but spared blood vessels, the esophagus, and phrenic nerves; after ablation, the myocardial tissue showed homogeneous fibrosis. Conclusion: The PFA system is safe and feasible in the preliminary porcine model, which can effectively isolate PVs and SVCs. Transmural tissue damage can be achieved without phrenic palsy or stenosis.