ArticleHeart rhythm O22021
Safety and efficacy aspects of pulsed field ablation catheters as a function of electrode proximity to blood and energy delivery method.
Article in Heart rhythm O2, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 19 citations in OpenAlex.
- Incidence of silent cerebral lesions during pulsed field ablation for paroxysmal atrial fibrillation.Annals of medicine · 2026Trial
- Three-Dimensional Left Atrial Geometry in Atrial Fibrillation: Imaging Biomarkers, Substrate Phenotyping, and Ablation Outcome Prediction.Diagnostics (Basel, Switzerland) · 2026Review
- One year outcomes of a fluoroless pulsed field ablation approach for atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Atrial fibrillation: from pathogenesis to novel treatment options.Molecular biomedicine · 2025Review
- Role of Computational Modelling in Enhancing Thermal Safety During Cardiac Ablation.Interdisciplinary cardiovascular and thoracic surgery · 2025Review
- Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures.Nature reviews. Cardiology · 2025Review
- Comparison of efficiency of PFA catheter designs by computer modeling.Journal of cardiovascular electrophysiology · 2024Article
- In Vitro Assay Development to Study Pulse Field Ablation Outcome Using Solanum Tuberosum.International journal of molecular sciences · 2024Article
- Efficacy and safety of pulsed field ablation for accessory pathways: a pilot study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Observational
- Emerging Tools and Techniques for Catheter Ablation of Cardiac Arrhythmias: A 2024 Update.The Journal of innovations in cardiac rhythm management · 2024Article
- Cardiac blood vessels and irreversible electroporation: findings from pulsed field ablation.Vessel plus · 2024Article
- Determination of lethal electric field threshold for pulsed field ablation inFrontiers in cardiovascular medicine · 2023Article
- Effect of Anisotropic Electrical Conductivity Induced by Fiber Orientation on Ablation Characteristics of Pulsed Field Ablation in Atrial Fibrillation Treatment: A Computational Study.Journal of cardiovascular development and disease · 2022Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulsed field ablation (PFA) is a promising technology based on electroporation. It is unclear if different catheter designs imply efficacy and safety differences.
objectiveTo vary geometry, blood exposure, and energy delivery methods among 3 representative catheter designs, and then compare lesion transmurality, extra-atrial safety, and embolic risk.
methodsA computed tomography-derived computer model was used. Balloon, flexible-circuit splined, and circular catheters were placed near the left pulmonary veins. Four energy delivery methods were tested: multi-unipolar, sequential unipolar, interlaced, and wide interlaced. A posterior wall target was defined. Efficacy was defined as percent target with >600 V/cm. Safety aspects included aortic/esophageal electroporation damage and a bubble-generation surrogate (electrode current density), with 90% transmurality requirement.
resultsBalloon catheters had highest efficacy, followed by flexible polymer splined and circular catheters. On energy delivery methods, the multi-unipolar one was most efficacious, followed by interlaced bipolar and sequential-unipolar ones. Electroporation risks to aorta and esophagus were highest with multi-unipolar energy delivery. Bubble risk was lowest with balloon catheters.
conclusionComputer models show that catheters with electrodes on a balloon surface or on flexible circuit splines are about 4 times more efficacious than circular catheters with electrodes exposed to atrial blood. Multi-unipolar energy delivery methods have a higher risk of electroporating aortic and esophageal tissue, when compared to bipolar interlaced methods. Considering embolic risks, circular catheters had the highest bubble-generating potential. A balloon or flexible circuit splined system with a wide interlaced delivery method showed the best balance in efficacy and safety.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.