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Myocardial lesion depth with circular electroporation ablation.

Fred H M Wittkampf¹, Vincent J van Driel, Harry van Wessel

¹Division of Heart and Lungs, the Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands. fredwittkampf@gmail.com

Circulation. Arrhythmia and Electrophysiology

|April 12, 2012

Summary

This summary is machine-generated.

Circular electroporation ablation in pigs created deep, continuous lesions, even with separate electrodes. Lesion depth increased with energy, suggesting potential for effective pulmonary vein isolation.

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Area of Science:

Cardiovascular Research
Electrophysiology
Medical Device Technology

Background:

Previous studies confirmed the feasibility and safety of circular electroporation ablation for pulmonary vein ostia.
The relationship between energy application magnitude and resulting lesion dimensions remained undetermined.

Purpose of the Study:

To investigate the correlation between energy application magnitude and lesion dimensions in circular electroporation ablation.
To assess the efficacy of creating continuous, deep lesions for pulmonary vein isolation in a porcine model.

Main Methods:

An in vivo porcine study utilized devices mimicking a 20-mm-diameter 7F circular ablation catheter on left ventricular epicardium submerged in blood.
Ablations were performed using two models (D with 10 electrodes, M with 1 electrode) at varying energy levels (50, 100, 200 J).
Lesion dimensions were measured after a 3-week survival period, with analysis of voltage waveforms and thermal damage.

Main Results:

All applications produced smooth voltage waveforms, indicating no vapor globe formation, arcing, or pressure waves.
Continuous, deep circular lesions were achieved at 200 J with model D, despite separate electrodes.
A significant positive correlation was found between applied current and lesion depth (0.17 mm/A).
No significant difference in lesion depth or width was observed between models D and M at 100 J.
No thermal damage was evident at the electrodes or ablation site immediately post-ablation.

Conclusions:

A single 200-J circular electroporation application in a porcine epicardial model created continuous lesions deep enough for pulmonary vein isolation.
Lesion continuity was maintained even with the use of separate electrodes.
Increased energy application magnitude directly correlated with increased lesion depth.