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Catheter-Tissue Contact Optimizes Pulsed Electric Field Ablation with a Large Area Focal Catheter
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  • Mary Clare Flaherty,
  • Shephal Doshi,
  • Jacob Laughner,
  • Melinda Quan,
  • Ante Anic
Mary Clare Flaherty
Galvanize Therapeutics Inc

Corresponding Author:[email protected]

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Shephal Doshi
Pacific Heart Institute
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Jacob Laughner
Galvanize Therapeutics Inc
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Melinda Quan
Galvanize Therapeutics Inc
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Ante Anic
Klinicki bolnicki centar Split
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Introduction: Pulsed electric field (PEF) ablation relies on the intersection of a critical voltage gradient with tissue to cause cell death. Field-based lesion formation with PEF technologies may still depend on catheter-tissue contact (CTC). The purpose of this study was to assess the impact of CTC on PEF lesion formation with an investigational large area focal (LAF) catheter in a preclinical model. Methods: PEF ablation via a 10-spline LAF catheter was used to create discrete RV lesions and atrial lesion sets in 10 swine (8 acute, 2 chronic). Local impedance (LI) was used to assess CTC. Lesions were assigned to 3 cohorts using LI above baseline: No Tissue Contact (NTC: ≤∆10Ω, close proximity to tissue), Low Tissue Contact (LTC: ∆11-29Ω), and High Tissue Contact (HTC: ≥∆30Ω). Acute animals were infused with triphenyl tetrazolium chloride (TTC) and sacrificed ≥2hrs post-treatment. Chronic animals were remapped 30 days post-index procedure and stained with infused TTC. Results: Mean (±SD) RV treatment sizes between LTC (n=14) and HTC (n=17) lesions were not significantly different (depth: 5.65±1.96mm vs 5.68±2.05mm, p=0.999; width: 15.68±5.22mm vs 16.98±4.45mm, p=0.737) while mean treatment size for NTC lesions (n=6) was significantly smaller (1.67±1.16mm depth, 5.97±4.48mm width, p<0.05). For atrial lesion sets, acute and chronic conduction block were achieved with both LTC (N=7) and HTC (N=6), and NTC resulted in gaps. Conclusions: PEF ablation with a specialized LAF catheter in a swine model is dependent on CTC. LI as an indicator of CTC may aid in the creation of consistent transmural lesions in PEF ablation.
17 Nov 2023Submitted to Journal of Cardiovascular Electrophysiology
17 Nov 2023Assigned to Editor
17 Nov 2023Submission Checks Completed
17 Nov 2023Review(s) Completed, Editorial Evaluation Pending
20 Nov 2023Reviewer(s) Assigned