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Updated: May 6, 2026
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
33.4K
Application repetition and electrode-tissue contact result in deeper lesions using a pulsed-field ablation circular
Luigi Di Biase1, Jacopo Marazzato1,2, Tara Gomez3
1Department of Cardiology, Montefiore Medical Center, 111 E 210th Street, Bronx, NY 10467, USA.
Summary
Pulsed-field ablation (PFA) lesion depth increases with repeated applications and better catheter contact. Effective PFA relies on biophysics, not just electrogram signal loss.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Pulsed-field ablation (PFA) is a novel, non-thermal method for targeting cardiac arrhythmias.
- Immediate electrogram (EGM) signal disappearance after PFA in pulmonary veins does not guarantee transmural lesion formation.
Purpose of the Study:
- To investigate the impact of application repetition and catheter-tissue contact on lesion formation during PFA.
- To determine if PFA endpoints are linked to biophysics rather than EGM attenuation.
Main Methods:
- Utilized a circular loop PFA catheter delivering repeated energy applications with varying contact forces.
- Employed vegetal potato and beating heart porcine ventricular models to assess lesion depth and contiguity.
- Evaluated the influence of application repetition, contact force, and catheter repositioning.
Main Results:
- Lesion formation was dependent on application repetition and catheter-tissue contact.
- In porcine ventricles, stacked applications yielded deeper lesions (4.4 ± 1.3 mm) than single applications (3.5 ± 0.7 mm).
- Increased catheter-tissue contact significantly enhanced lesion depth and contiguity in vegetal models.
Conclusions:
- Both repetition of PFA applications and catheter contact independently contribute to deeper lesion formation.
- Effective PFA endpoints are determined by the underlying biophysics of the energy delivery, not solely by EGM signal attenuation.
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