Endocardial ventricular pulsed field ablation: a proof-of-concept preclinical evaluation.

Area of Science:

• Cardiovascular Research
• Medical Device Technology
• Electrophysiology

Background:

• Pulsed field ablation (PFA) is an emerging non-thermal cardiac ablation technique.
• It utilizes ultra-short electrical impulses to selectively destroy myocardial tissue.
• PFA aims to spare adjacent non-target tissues from thermal injury.

Purpose of the Study:

• To assess the safety and feasibility of ventricular PFA.
• To evaluate a prototype steerable, endocardial catheter for PFA delivery.
• To characterize the lesions created by PFA in healthy swine ventricles.

Main Methods:

• PFA was performed on the left and right ventricles of four healthy swine using a prototype 12-Fr catheter.
• Electrograms and pacing thresholds were recorded pre- and post-ablation.
• Histological analysis was conducted after 35.5 days to evaluate lesion characteristics.

Main Results:

• 39 PFA applications resulted in significant electrogram reduction without ventricular arrhythmias.
• Pacing thresholds increased significantly, with non-capture at maximum amplitude in 80% of sites.
• Histology revealed homogeneous, myocardium-specific lesions with preserved nerves and vasculature.

Conclusions:

• Endocardial PFA is feasible using the prototype catheter.
• PFA creates homogeneous, myocardium-specific lesions.
• The technique shows potential for targeted cardiac tissue ablation with collateral tissue sparing.