Luigi Di Biase, Jacopo Marazzato, Assaf Govari, Andreas Altman, Christopher Beeckler, Joe Keyes, Tushar Sharma, Vito Grupposo, Fengwei Zou, Masafumi Sugawara, Atsushi Ikeda, Farshad Raissi, Rahul Bhardwaj, Jonathan C Hsu, Mark Lee, Rajesh Banker, Sanghamitra Mohanty, Andrea Natale, Qi Chen, Paras Parikh, Xiaodong Zhang, Hiroshi Nakagawa
{"title":"脉冲场消融指数引导的病变形成消融：心室模型中接触力和应用次数的影响","authors":"Luigi Di Biase, Jacopo Marazzato, Assaf Govari, Andreas Altman, Christopher Beeckler, Joe Keyes, Tushar Sharma, Vito Grupposo, Fengwei Zou, Masafumi Sugawara, Atsushi Ikeda, Farshad Raissi, Rahul Bhardwaj, Jonathan C Hsu, Mark Lee, Rajesh Banker, Sanghamitra Mohanty, Andrea Natale, Qi Chen, Paras Parikh, Xiaodong Zhang, Hiroshi Nakagawa","doi":"10.1161/CIRCEP.123.012717","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The effect of contact force (CF) on lesion formation is not clear during pulsed field ablation (PFA). The aim of this study was to evaluate the impact of CF, PFA, and their interplay through the PFA index (PF index) formula on the ventricular lesion size in swine.</p><p><strong>Methods: </strong>PFA was delivered through the CF-sensing OMNYPULSE catheter. Predefined PFA applications (×3, ×6, ×9, and ×12) were delivered maintaining low (5-25 g), high (26-50 g), and very high (51-80 g) CFs. First, PFA lesions were evaluated on necropsy in 11 swine to investigate the impact of CF/PFA-and their integration in the PF index equation-on lesion size (study characterization). Then, 3 different PF index thresholds-300, 450, and 600-were tested in 6 swine to appraise the PF index accuracy to predict the ventricular lesion depth (study validation).</p><p><strong>Results: </strong>In the study characterization data set, 111 PFA lesions were analyzed. CF was 32±17 g. The average lesion depth and width were 3.5±1.2 and 12.0±3.5 mm, respectively. More than CF and PFA dose alone, it was their combined effect to impact lesion depth through an asymptotically increasing relationship. Likewise, not only was the PF index related to lesion depth in the study validation data set (r<sup>2</sup>=0.66; <i>P</i><0.001) but it also provided a prediction accuracy of the observed depth of ±2 mm in 69/73 lesions (95%).</p><p><strong>Conclusions: </strong>CF and PFA applications play a key role in lesion formation during PFA. Further studies are required to evaluate the best PFA ablation settings to achieve transmural lesions.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":null,"pages":null},"PeriodicalIF":9.1000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11017832/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pulsed Field Ablation Index-Guided Ablation for Lesion Formation: Impact of Contact Force and Number of Applications in the Ventricular Model.\",\"authors\":\"Luigi Di Biase, Jacopo Marazzato, Assaf Govari, Andreas Altman, Christopher Beeckler, Joe Keyes, Tushar Sharma, Vito Grupposo, Fengwei Zou, Masafumi Sugawara, Atsushi Ikeda, Farshad Raissi, Rahul Bhardwaj, Jonathan C Hsu, Mark Lee, Rajesh Banker, Sanghamitra Mohanty, Andrea Natale, Qi Chen, Paras Parikh, Xiaodong Zhang, Hiroshi Nakagawa\",\"doi\":\"10.1161/CIRCEP.123.012717\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The effect of contact force (CF) on lesion formation is not clear during pulsed field ablation (PFA). The aim of this study was to evaluate the impact of CF, PFA, and their interplay through the PFA index (PF index) formula on the ventricular lesion size in swine.</p><p><strong>Methods: </strong>PFA was delivered through the CF-sensing OMNYPULSE catheter. Predefined PFA applications (×3, ×6, ×9, and ×12) were delivered maintaining low (5-25 g), high (26-50 g), and very high (51-80 g) CFs. First, PFA lesions were evaluated on necropsy in 11 swine to investigate the impact of CF/PFA-and their integration in the PF index equation-on lesion size (study characterization). Then, 3 different PF index thresholds-300, 450, and 600-were tested in 6 swine to appraise the PF index accuracy to predict the ventricular lesion depth (study validation).</p><p><strong>Results: </strong>In the study characterization data set, 111 PFA lesions were analyzed. CF was 32±17 g. The average lesion depth and width were 3.5±1.2 and 12.0±3.5 mm, respectively. More than CF and PFA dose alone, it was their combined effect to impact lesion depth through an asymptotically increasing relationship. Likewise, not only was the PF index related to lesion depth in the study validation data set (r<sup>2</sup>=0.66; <i>P</i><0.001) but it also provided a prediction accuracy of the observed depth of ±2 mm in 69/73 lesions (95%).</p><p><strong>Conclusions: </strong>CF and PFA applications play a key role in lesion formation during PFA. Further studies are required to evaluate the best PFA ablation settings to achieve transmural lesions.</p>\",\"PeriodicalId\":10319,\"journal\":{\"name\":\"Circulation. 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Pulsed Field Ablation Index-Guided Ablation for Lesion Formation: Impact of Contact Force and Number of Applications in the Ventricular Model.
Background: The effect of contact force (CF) on lesion formation is not clear during pulsed field ablation (PFA). The aim of this study was to evaluate the impact of CF, PFA, and their interplay through the PFA index (PF index) formula on the ventricular lesion size in swine.
Methods: PFA was delivered through the CF-sensing OMNYPULSE catheter. Predefined PFA applications (×3, ×6, ×9, and ×12) were delivered maintaining low (5-25 g), high (26-50 g), and very high (51-80 g) CFs. First, PFA lesions were evaluated on necropsy in 11 swine to investigate the impact of CF/PFA-and their integration in the PF index equation-on lesion size (study characterization). Then, 3 different PF index thresholds-300, 450, and 600-were tested in 6 swine to appraise the PF index accuracy to predict the ventricular lesion depth (study validation).
Results: In the study characterization data set, 111 PFA lesions were analyzed. CF was 32±17 g. The average lesion depth and width were 3.5±1.2 and 12.0±3.5 mm, respectively. More than CF and PFA dose alone, it was their combined effect to impact lesion depth through an asymptotically increasing relationship. Likewise, not only was the PF index related to lesion depth in the study validation data set (r2=0.66; P<0.001) but it also provided a prediction accuracy of the observed depth of ±2 mm in 69/73 lesions (95%).
Conclusions: CF and PFA applications play a key role in lesion formation during PFA. Further studies are required to evaluate the best PFA ablation settings to achieve transmural lesions.
期刊介绍：
Circulation: Arrhythmia and Electrophysiology is a journal dedicated to the study and application of clinical cardiac electrophysiology. It covers a wide range of topics including the diagnosis and treatment of cardiac arrhythmias, as well as research in this field. The journal accepts various types of studies, including observational research, clinical trials, epidemiological studies, and advancements in translational research.
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