Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-AB24 - Efficacy, Safety, and Potential Advantages of a New Energy Source for Catheter Ablation of Myocardial Tissue (ID 21) Abstract

D-AB24-03 - Durability And Safety Of Vein Isolation And Linear Atrial Lesions With Pulsed Field Ablation Using A 9mm Lattice-tip Catheter: A Preclinical Assessment (ID 800)

Abstract

Background: Point by point ablation permits flexible lesion sets during AF ablation. A novel pulsed field ablation (PFA) waveform can be delivered and tracked using a focal 9mm lattice-tip ablation catheter and electroanatomical mapping system (Sphere-9 and Prism-1, respectively; Affera Inc).
Objective: To assess the feasibility, safety and durability of thoracic vein (TV) isolation and linear ablation using focal PFA in swine.
Methods: Twelve swine underwent transfemoral venous access under general anesthesia. Four different PF doses (2 low and 2 high doses) were used to ablate a total of 25 TVs: 13 PVs, 12 SVCs and 5 posterior right atrial (RA) lines. TV potentials, RA voltage and phrenic pacing were assessed both acutely and at follow up with high density mapping.
Results: All 25 targeted veins (100%) were acutely isolated and all 5 (100%) RA lines were continuous with conduction block verified by activation mapping. Mean number of PFA applications to PVs, SVC and RA ranged between 10.5 to 13.8 with total ablation times of 44.9 to 83.2 seconds (Table). Durable isolation was achieved in 12 /13 (92%) PVs and 8 /12 (67%) SVCs. RA lines were continuous and blocked in in 4 of 4 animals at follow up (one line was not assessed). Isolation was durable with the higher dose (12 of 12 veins isolated) compared to the lower dose (8 of 13 isolated; p=0.016); this improvement was primarily with SVC durability. Phrenic nerve capture was preserved in all swine. Bubbles were not observed during PFA by ICE imaging.
Conclusion: The 9mm lattice-tip catheter can deliver focal PFA at various atrial sites. Used with the compatible mapping system, the catheter can achieve highly durable electrical endpoints relevant to AF ablation.
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