B-PO01-047 Pulsed Field Ablation and Heat Generation: Electrode-Tissue Temperature Analysis From the Pulsed AF Trial
Background: Pulsed Field Ablation (PFA) is an emerging alternative energy source to thermal-based ablation. PULSED AF is a first-in-human study evaluating the safety and efficacy of PFA for pulmonary vein (PV) isolation, but the thermal effects of PFA on human myocardial tissue are unknown. Objective: Quantify the electrode temperature rise following PFA energy application in PULSED AF patients .Methods: Patients (n=20) undergoing first-time PV isolation were treated with PFA using a circular, over-the-wire catheter. Electrode temperature was recorded from all 9 electrodes for 1 second following each PFA application. Thermocouples were located on the tissue side of the gold electrodes to provide tissue-interface temperatures. Results: Acute PV isolation was achieved in 100% of PVs without PFA system related serious adverse events. Different PFA levels showed the following temperature rises: 1.7 ± 1.6°C (1200 V), 1.9 ± 2.0°C (1400 V) and 3.0 ± 3.0°C (1500 V) (r2=0.9). Electrode temperature rise at the 1500 V varied slightly across all four veins with temperature rises of 3.2 ± 2.8°C (LSPV) 3.6 ± 3.7°C (LIPV) 2.9 ± 2.7°C (RSPV) 2.8 ± 3.0°C (RIPV). In patents with esophageal temperature monitoring, no appreciable changes were observed (n=8). Conclusion: This is the first electrode temperature analysis associated with PFA. PFA only causes a limited temperature rise following delivery confirming the primarily non-thermal nature of lesion creation.
Verma A Boersma LVA, Haines DE, Marchlinksk FE, Calkins H, Sanders P et al. B-POO1-047 Pulsed filed ablation and heat generation: Electrode-tissue temperature analysis from the pulsed AF trial. Heart Rhythm 2021 Aug: 18(8 Supplement) Volume 18, Issue 8, Supplement, p. S70.