Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-165 - Effective Dose Of Pulsed Field Ablation To Achieve Pulmonary Vein Isolation (ID 123)


Background: Pulsed field ablation (PFA) is an emerging technology for ablation; however, the effective dose of PFA required to reproducibly achieve pulmonary vein isolation is not known
Objective: Examine the effective and safe dose of bipolar PFA in a canine model
Methods: In this canine model, 6 animals were studied using three different levels of PFA (1000V, 1200V and 1400V). Two animals were assigned to each level. A circular multielectrode ablation catheter (PVAC™ GOLD) was used. A Medtronic PFA generator was used to deliver PFA at the antrum of each individual vein using a single level. A minimum of three and maximum of eight ablations were performed in each vein with an endpoint of entrance and exit block. Each vein was individually assessed at the end of procedure
Results: The median number of PFA applications to PV isolation was 3.5±1.9 for 1400V, 4±1.1 for 1200V, and 6±2.4 for 1000V. The 1000V level required more applications compared to the higher levels (p=0.3 ). Entrance block was achieved in 62% of PVs using 1000V and 100% of PVs using higher doses. Exit block was achieved in 75% of PVs using 1000V and 100% of the PVs using higher doses. The mean EGM amplitude pre-ablation was 1.7±1.5mV (1400V), 1.9±1.0mV(1200V), and 1.5±1.3mV(1000V). The mean post ablation amplitude was 0.1±0.1mV, 0.1±0.1mV, and 0.2±0.1mV from high to low doses (Figure 1). There was no significant difference in EGM amplitude reduction based on the dose of PFA (p=0.9 )
Conclusion: This study demonstrated the efficacy of three levels of PFA in canines. Acute EGM amplitude reduction was similar in all three dosing groups, but bidirectional block was achieved in 100% of PVs using the higher doses and less than 75% of PVs using the lower dose