Comparative Efficacy and Safety of Pulsed Field Ablation Versus Radiofrequency Ablation of Idiopathic LV Arrhythmias

• DOI: 10.1016/j.jacep.2024.04.025
• Publication Date: 2024-06-13T00:27:35Z
• Authors: Arwa Younis; Chadi Tabaja; Ryan Kleve; Kara Garrott; Lauren Lehn; Eric Buck; Ayman A. Hussein; Shady Nakhla; Hiroshi Nakagawa; Alison Krywanczyk; Tyler Taigen; Mohamed Kanj; Jakub Sroubek; Walid I. Saliba; Oussama M. Wazni; Pasquale Santangeli
• Keywords: Interventricular septum

Comparative efficacy and safety data on radiofrequency ablation (RFA) versus pulsed field (PFA) for common idiopathic left ventricular arrhythmia (LV-VAs) locations are lacking. This study sough to compare RFA with PFA of LV-VAs locations. Ten swine were randomized or LV interventricular septum, papillary muscle, summit via distal coronary sinus, epicardium subxiphoid approach. Ablations delivered using an investigational dual-energy (RFA/PFA) contact force (CF) local impedance-sensing catheter. After 1-week survival, animals euthanized lesion assessment. A total 55 (4 applications/site 2.0 KV, target CF ≥10 g) 36 (CF g, 25–50 W targeting ≥50 Ω impedance drop, 60-second duration) performed. septum: average depth 7.8 mm vs 7.9 (P = 0.78) no adverse events. Papillary muscle: 8.1 4.5 < 0.01). Left summit: 5.6 2.7 Steam-pop and/or fibrillation in 4 12 0 0.01), ST-segment changes observed. Epicardium: 6.4 3.3 Transient elevations/depressions occurred 5 the arm Angiography acutely at 7 days showed normal coronaries all cases. In this study, compared RFA, produced deeper lesions fewer steam pops. However, was associated higher rates transient elevations depressions direct ablation.