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PO-04-159 LARGE VOLUME VENTRICULAR ABLATION USING A NOVEL INSTANTANEOUS ABLATION SYSTEM
Abstract   Peer reviewed

PO-04-159 LARGE VOLUME VENTRICULAR ABLATION USING A NOVEL INSTANTANEOUS ABLATION SYSTEM

P. Konstantina (Konna) Zoga, Eric D. Buck, Jonathan A. Salas, Philippa Hill, Christopher Schneider and Steven R. Mickelsen
Heart rhythm, Vol.23(4 Supplement), pp.S708-S708
04/2026
DOI: 10.1016/j.hrthm.2026.03.1178

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Abstract

Background Radiofrequency ablation often requires extended procedure times to create effective ventricular lesions. Pulsed Field Ablation (PFA) has emerged as an alternative due to tissue selectivity and rapid lesion formation. Field Medical Inc. has developed a PFA system for ventricular ablation, enabling creation of large-volume lesions in the left ventricle (LV). Objective To characterize high-volume LV lesion creation performance and hemolysis of a novel PFA system (Field Medical Inc., CA) in a chronic porcine model. Methods Six naïve Yorkshire swine (65–85 kg) subjects were anesthetized and prepared for catheter ablation in typical aseptic fashion. Ablations were performed using the FieldForce Catheter (<200 msec per ablation). Animals received an average of 166.7 ± 20.7 ablations (mean ± SD) in the mid-lateral region of the LV and were survived for 5.3 ± 0.5 days. After humane euthanasia, hearts were explanted and lesion dimensions were assessed. Lesions were modeled as ellipsoids to estimate surface area and volume. Plasma Free Hemoglobin (PFH) was assessed pre-ablation, post-ablation, and on Day 2 of survival in a subset of subjects. Results All porcine subjects survived the duration of the survival period without adverse events. Large, continuous lesions were created in each subject (Table 1), with mean depth 9.4 ± 1.0 mm and mean total energy delivery time of 25.0 ± 3.1 seconds. Mean post-ablation PFH was 54.3 ± 17.5 mg/dL, and in the subset of subjects in whom PFH was assessed on Day 2 of survival, values had returned to baseline levels (<10 mg/dL) by Day 2. Conclusion Large volume, instantaneous ablation of the LV with PFA was well tolerated in these subjects. Mean lesion volumes greater than 24 cm3 were achieved with short-duration ablation. This study demonstrates the feasibility of rapidly creating large homogeneous LV ablations with transient hemolytic response. These findings highlight the need for further investigation into rapid, large-volume PFA lesion creation.

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