Abstract
PO-01-160 FEASIBILITY OF ISCHEMIC SCAR HOMOGENIZATION WITH A NOVEL CONTACT FORCE ENABLED FOCAL PULSE FIELD ABLATION CATHETER
Heart rhythm, Vol.21(5 Supplement), p.S157
05/2024
DOI: 10.1016/j.hrthm.2024.03.571
Abstract
Background
Ischemic scar homogenization with radiofrequency ablation (RFA) has been shown highly effective to achieve long-term control of ventricular tachycardia (VT), but it remains a lengthy procedure and complete electrogram abolition cannot always be achieved.
Objective
We evaluated the feasibility of ischemic scar homogenization with a novel contact force enabled focal pulse field ablation (PFA) catheter in a swine model of healed myocardial infarction.
Methods
Three swine (60±5 kg) underwent 120-minute occlusion of the left anterior descending coronary artery and survived for 4 weeks. Animals underwent cardiac magnetic resonance (CMR) followed by endocardial high-density mapping to delineate the bipolar voltage scar (0.5-1.5 mV and/or split/fragmented/late electrograms) and PFA-based scar homogenization. Ablation was performed with the novel FieldForce® (Field Medical, CA) ablation system, which consists of an 8.5-Fr single point, bidirectional, contact force sensing catheter and a proprietary PFA generator. The system delivers trains of monophasic pulses for a total duration of ∼200 microseconds. Post-ablation remapping is planned at 2 days, 2 weeks and 4 weeks.
Results
The baseline anterior-apical infarct volume assessed by late gadolinium enhancement on CMR was 10 ml ± 3.l ml (11.6 ±6.7% of the LV volume). Electroanatomic mapping confirmed anterior-apical bipolar voltage scar with an average area of 10 ± 8 cm2. Complete scar homogenization with abolition of all the targeted electrograms was achieved in all cases with an average of 4 PFA lesions per animal (12 lesions total). One animal underwent endo-epicardial remapping 2 days post-procedure with evidence of persistent scar silencing.
Conclusion
In this animal model of myocardial infarction, scar-homogenization with a novel contact force enabled focal PFA catheter was feasible and acutely effective with complete scar silencing immediately after ablation and at 2 days remapping. Remapping at 2 weeks and 4 weeks post-procedure are pending.
Details
- Title: Subtitle
- PO-01-160 FEASIBILITY OF ISCHEMIC SCAR HOMOGENIZATION WITH A NOVEL CONTACT FORCE ENABLED FOCAL PULSE FIELD ABLATION CATHETER
- Creators
- Ioan LiubaSteven R. MickelsenChadi TabajaArwa YounisChristopher NguyenMasafumi SugawaraSojin Y. WassKoji HiguchiJakub SroubekOussama M. WazniPasquale Santangeli
- Resource Type
- Abstract
- Publication Details
- Heart rhythm, Vol.21(5 Supplement), p.S157
- DOI
- 10.1016/j.hrthm.2024.03.571
- ISSN
- 1547-5271
- eISSN
- 1556-3871
- Language
- English
- Date published
- 05/2024
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984649047502771
Metrics
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