Point-by-Point Pulsed Field Ablation Using a Multimodality Generator and a Contact Force-Sensing Ablation Catheter:...

Area of Science:

• Cardiovascular Ablation Technologies
• Electrophysiology Research
• Preclinical Animal Models

Background:

• Pulsed field ablation (PFA) is an emerging alternative to radiofrequency ablation (RFA).
• Limited data exists on focal point-by-point PFA efficacy and safety.
• This study investigates focal PFA versus RFA in a preclinical swine model.

Purpose of the Study:

• To compare lesion durability between focal PFA and RFA.
• To assess collateral damage associated with focal PFA and RFA.
• To evaluate histological differences in scar formation post-ablation.

Main Methods:

• Eighteen swine underwent randomized focal ablation using low-dose PFA, high-dose PFA, or RFA.
• A contact force-sensing catheter delivered energy to pulmonary veins and atrial sites.
• Animals were assessed via remapping, necropsy, and histology at 28 days post-ablation.

Main Results:

• All targeted sites achieved successful ablation with persistent pulmonary vein isolation (100%) and durable lesions (98%).
• Lesion size and transmurality were similar between PFA and RFA groups.
• PFA demonstrated more mature scar formation without necrosis or inflammation, and no collateral damage was observed.

Conclusions:

• Focally delivered PFA, guided by contact force, creates durable lesions and mature scars.
• PFA shows comparable efficacy to RFA with a favorable safety profile in a preclinical setting.
• Further research is warranted to explore the long-term feasibility of focal PFA for atrial fibrillation treatment.