Determination of lethal electric field threshold for pulsed field ablation in ex vivo perfused porcine and human hearts

• DOI: 10.3389/fcvm.2023.1160231
• Publication Date: 2023-06-24T14:46:40Z
• Authors: Bor Kos; Lars Mattison; David Ramirez; Helena Cindrič; Daniel C. Sigg; Paul A. Iaizzo; Mark T. Stewart; Damijan Miklavčič
• Keywords: Ex vivo

Pulsed field ablation is an emerging modality for catheter-based cardiac ablation. The main mechanism of action irreversible electroporation (IRE), a threshold-based phenomenon in which cells die after exposure to intense pulsed electric fields. Lethal threshold IRE tissue property that determines treatment feasibility and enables the development new devices therapeutic applications, but it greatly dependent on number pulses their duration.In study, lesions were generated by applying porcine human left ventricles using pair parallel needle electrodes at different voltages (500-1500 V) two pulse waveforms: proprietary biphasic waveform (Medtronic) monophasic 48 × 100 μs pulses. lethal threshold, anisotropy ratio, conductivity increase determined numerical modeling, comparing model outputs with segmented lesion images.The median was 535 V/cm ((N = 51 n 6 hearts) 416 donor hearts 21 3 waveform. value 368 35 9 cm pulses.The values obtained are compared extensive literature review published thresholds other tissues found be lower than most tissues, except skeletal muscle. These findings, albeit preliminary, from limited suggest treatments humans parameters optimized pigs should result equal or greater lesions.