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Electroporation using pulsed field ablation (PFA) is emerging as a promising technology for pulmonary vein isolation. Because of the atria's thin wall, most of the ablations performed in the atrium achieve transmural lesions. However, the association between PFA field strength and lesion size is not well documented.
To evaluate the association between PFA field strength and lesion size
In this study, eight canines underwent bipolar PFA ablations in the ventricles using three different PFA field strengths. Eight dogs underwent right and left ventricular ablations using 1100 V, 1300 V, and 1500 V. Energy was delivered between a decapolar catheter placed either in the coronary sinus or the left pulmonary artery and a standard RF ablation catheter. Canines were humanely euthanized after the ablations and underwent histological study.
Thirty-three ablation were performed, and 30 lesions were identified for histological examination. The mean lesion depth was 5.5±1.9 mm for 1100 V (n=11), 6.1±1.5 mm for 1300 V (n=9), and 5.7±1.6 mm for 1500 V (n=10, P > 0.05). However, the lesion width has increased by incrementing field strength from 6.9±1.1 mm to 8.6±1.1 mm and 9.8±2.5 mm (Figure). The lesions created by higher doses of PFA were significantly wider than those created with lower PFA doses.