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Have the cake and eat it too: a case of a technological miracle?
  • Boaz Avitall
Boaz Avitall
University of Illinois at Chicago

Corresponding Author:[email protected]

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1. Using the Farapulse pulse configuration and ablation procedure results in a significant esophageal temperature increase that is underestimated using the Circa probe and it is likely significantly higher temperature can be recorded at close proximity to the ablation electrodes. 2. A near-field tissue ablation is a mix of irreversible electroporation and thermal injury. 3. The bipolar energy delivery using the Farawave-catheter limits the field and thermal ablation to close proximity to the bipolar ablation electrodes limiting the impact on extracardiac tissues. 4. In the two published papers accompanying this editorial, the Farapulse PFA technology is shown to have no short or long-term adverse effect on the esophagus. However, reported phrenic nerve conduction stunning may occur (7,8). It is also noted that while Meininghaus et al. reported significant esophageal acute injuries using RF and Cryo no long-term data is provided that these findings resulted in long-term disabilities. 5. PFA is hampered by the inability to adequately assess irreversible lesion formation in real-time. 6. The advantage provided by using PFA ablation technology is added safety and faster procedure time. These conclusions need further affirmation when the technology is widely used.
23 Oct 2023Submitted to Journal of Cardiovascular Electrophysiology
24 Oct 2023Assigned to Editor
24 Oct 2023Submission Checks Completed
24 Oct 2023Review(s) Completed, Editorial Evaluation Pending
26 Oct 2023Editorial Decision: Accept