Pulsed Field Ablation Therapy Parameters: Enhancing Lesion Depth While Reducing Musculoskeletal Stimulation and Thermal Response in an Irrigated Tip Catheter: A Comprehensive Study Using In Silico, In Vitro, and In Vivo Models.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Pulsed Field Ablation Therapy Parameters: Enhancing Lesion Depth While Reducing Musculoskeletal Stimulation and Thermal Response in an Irrigated Tip Catheter: A Comprehensive Study Using In Silico, In Vitro, and In Vivo Models.
Συγγραφείς:	Verma A; McGill University Health Centre, Montreal, QC, Canada (A.V.)., Barbhaiya C; New York University Langone Health (C.B.)., Friedman DJ; Duke University Medical Center, Durham, NC (D.J.F., J.P.P.)., Piccini JP; Duke University Medical Center, Durham, NC (D.J.F., J.P.P.).
Πηγή:	Circulation. Arrhythmia and electrophysiology [Circ Arrhythm Electrophysiol] 2026 Sep; Vol. 19 (9), pp. e014955. Date of Electronic Publication: 2026 Aug 19.
Τύπος έκδοσης:	Journal Article
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101474365 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1941-3084 (Electronic) Linking ISSN: 19413084 NLM ISO Abbreviation: Circ Arrhythm Electrophysiol Subsets: MEDLINE
Imprint Name(s):	Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Ιατρικοί όροι (MeSH):	Therapeutic Irrigation/instrumentation , Therapeutic Irrigation/adverse effects , Catheter Ablation/instrumentation , Catheter Ablation/adverse effects , Catheter Ablation/methods , Computer Simulation , Cardiac Catheters*, Animals ; Dogs ; Cattle ; Equipment Design ; Irreversible Electroporation Therapy ; Hot Temperature ; Models, Animal
Περίληψη:	Background: Pulsed field ablation therapies need to be optimized to maximize lesion depth while mitigating heat and musculoskeletal stimulation. We describe the adjustment of biphasic pulsed field ablation parameters for an irrigated tip catheter. Methods: Experimental models all used an 8F, flexible-tip, irrigated ablation catheter. Computer simulation models were designed to assess the effects of bipolar versus monopolar applications. A vegetal (potato) model was used to assess the effects of voltage, pulse width, and number of pulses per burst on lesion depth. In-vitro testing on bovine cardiac muscle was performed with temperature sensors at the surface and 3 and 7 mm beneath the surface to measure temperature rises. Finally, an in vivo canine model was used to assess for musculoskeletal stimulation caused by the pulsed field ablation therapies established with the vegetal/in vitro testing. Results: Monopolar delivery consistently delivered more tissue depth than bipolar configurations. Adjustments from n to n+1.0 µs and increasing pulses per burst from 50 to 250 increased lesion depth but also increased musculoskeletal stimulation. The optimized burst count was 5 R-wave-gated bursts over 4 to 9 seconds. The optimized therapy had a minimal observed depth of >5 mm and minimized musculoskeletal stimulation. Final selected therapies did create temperature rises, which were completely offset by irrigation rates of 7 to 13 mL/min. Conclusions: Pulse width and number of pulses per burst are important contributors to lesion depth, musculoskeletal stimulation, and incident heating. Even small adjustments in these parameters can alter lesion depth, muscle stimulation, and thermal effects, which will differentiate optimal from suboptimal pulsed field ablation.
Competing Interests:	Dr Verma reports grants from JNJ MedTech, Medtronic, and Abbott. He advises for JNJ MedTech, Medtronic, Abbott, Volta Medical, Kardium, and Adagio Medical. Dr Barbhaiya reports consulting fees/honoraria from Abbott, J&J MedTech, and Biotronik. Dr Friedman reports research grants from Abbott, Boston Scientific, Medtronic, and Philips and received consulting fees from Abbott, Alleviant, Boston Scientific, and Medtronic. Dr Piccini reports grants for clinical research from Abbott, the American Heart Association, iRhythm, and Philips and serves as a consultant to Abbott, Medtronic, Milestone Pharmaceuticals, Novartis, Philips, PhysCade, Sanofi, SymKardia, and UpToDate. He serves on data safety and monitoring boards for Kardium and Conformal.
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Contributed Indexing:	Keywords: animal; catheter; computer simulation; heating; temperature
Entry Date(s):	Date Created: 20260819 Date Completed: 20260915 Latest Revision: 20260918
Update Code:	20260918
PubMed Central ID:	PMC13581297
DOI:	10.1161/CIRCEP.126.014955
PMID:	42615125
Βάση Δεδομένων:	MEDLINE

Περιγραφή
ISSN:	1941-3084
DOI:	10.1161/CIRCEP.126.014955