Basic/Translational Science -> Whole Animal Electrophysiology and Pharmacology (includes Neurohumoral Modulation) D-PO05 - Poster Session V (ID 39) Poster

D-PO05-061 - Extent Of Myocardial Injury And Collateral Damage Following Electroporation Using Pulsed Field Ablation As Determined Via Intraprocedural Monitoring (ID 530)


Background: Pulsed Field Ablation (PFA) for myocardial ablation is an emerging technology. The extent of myocardial injury and collateral damage using PFA is not well documented.
Objective: Evaluate the extent of myocardial injury, inflammatory response, and collateral damage using PFA in the right and left atrium in canines.
Methods: In 6 canines, 24 pulmonary veins, 6 right atrial appendages, and 6 superior vena cava (SVC) were ablated using a Medtronic PFA generator with a circular multielectrode catheter (PVACTM GOLD). Systemic blood samples were collected pre and post procedure. Left atrial (LA) blood samples were collected after trans-septal puncture and post procedure. An oesophageal temperature probe was placed prior to the procedure (CIRCA-S CATH™) . Right phrenic nerve stimulation was performed to check for palsy pre and post SVC ablation.
Results: In total, 144 PFA deliveries were made (22.5±4.8 per dog). An inflammatory response following PFA was observed. The LA white cell count increased from 5.4±0.6 to 11.0±3.0 (P= 0.11). There was a significant rise in LA hsCRP following ablation (P= 0.002). Systemic troponin pre-ablation was 8±1ng/L elevated to 55347±23637ng/L post ablation (Figure 1). Plasma free haemoglobin increased from 5.4±0.6mg/dL pre-ablation to 11.0±3.0mg/dL post-ablation indicating no significant haemolysis. No oesophageal temperature rise was observed. No phrenic nerve palsy was observed post SVC ablation.
Conclusion: Myocardial injury and localised LA inflammatory response was produced by PFA in this canine experiment. No acute signs of collateral damage were observed with negligible haemolysis, no oesophageal temperature rise or phrenic nerve palsy.