ArticlePloS one2023
How intramyocardial fat can alter the electric field distribution during Pulsed Field Ablation (PFA): Qualitative findings from computer modeling.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 12 citations in OpenAlex.
- Context-dependent interactions between variable-loop pulsed field ablation and cardiac implantable electronic devices: a controlled preclinical study.European heart journal open · 2026Article
- Pulsed Field Ablation for Atrial Fibrillation in Obesity: Reassessing Risk, Safety, and Success.Journal of clinical medicine · 2026Review
- Epicardial adipose tissue and ablation outcomes in obese patients with paroxysmal atrial fibrillation: A comparison of pulsed field and radiofrequency ablation.Heart rhythm O2 · 2025Article
- Role of Computational Modelling in Enhancing Thermal Safety During Cardiac Ablation.Interdisciplinary cardiovascular and thoracic surgery · 2025Review
- Effects of electric field and heat distribution due to trends in metal stent diameter in epicardial pulsed field ablation.Scientific reports · 2025Article
- Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation?Heart rhythm O2 · 2025Article
- Durability of Pulsed Field Ablation Lesions: Current Understanding and Future Directions.Arrhythmia & electrophysiology review · 2025Review
- Pulsed electric field ablation process-a study of the effect of different shapes (materials) of metal stents on the ablation effect.Frontiers in cardiovascular medicine · 2025Article
- Feasibility study of intravascular pulsed electric field ablation for the treatment of cardiac arrhythmias.Frontiers in physiology · 2025Article
- Contemporary Trends in Pulsed Field Ablation for Cardiac Arrhythmias.Journal of cardiovascular development and disease · 2024Review
- Biophysics and electrophysiology of pulsed field ablation in normal and infarcted porcine cardiac ventricular tissue.Scientific reports · 2024Article
- The Effects of Interphase and Interpulse Delays and Pulse Widths on Induced Muscle Contractions, Pain and Therapeutic Efficacy in Electroporation-Based Therapies.Journal of cardiovascular development and disease · 2023Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Even though the preliminary experimental data suggests that cardiac Pulsed Field Ablation (PFA) could be superior to radiofrequency ablation (RFA) in terms of being able to ablate the viable myocardium separated from the catheter by collagen and fat, as yet there is no formal physical-based analysis that describes the process by which fat can affect the electric field distribution. Our objective was thus to determine the electrical impact of intramyocardial fat during PFA by means of computer modeling. Computer models were built considering a PFA 3.5-mm blunt-tip catheter in contact with a 7-mm ventricular wall (with and without a scar) and a 2-mm epicardial fat layer. High voltage was set to obtain delivered currents of 19, 22 and 25 A. An electric field value of 1000 V/cm was considered as the lethal threshold. We found that the presence of fibrotic tissue in the scar seems to have a similar impact on the electric field distribution and lesion size to that of healthy myocardium only. However, intramyocardial fat considerably alters the electrical field distribution and the resulting lesion shape. The electric field tends to peak in zones with fat, even away from the ablation electrode, so that 'cold points' (i.e. low electric fields) appear around the fat at the current entry and exit points, while 'hot points' (high electric fields) occur in the lateral areas of the fat zones. The results show that intramyocardial fat can alter the electric field distribution and lesion size during PFA due to its much lower electrical conductivity than that of myocardium and fibrotic tissue.
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