Evidence map›Paper›PMID 37994554›Full record

ArticleCirculation. Arrhythmia and electrophysiology2023

Point-by-Point Pulsed Field Ablation Using a Multimodality Generator and a Contact Force-Sensing Ablation Catheter: Comparison With Radiofrequency Ablation in a Remapped Chronic Swine Heart.

Luigi Di Biase, Jacopo Marazzato, Fengwei Zou, Aung Lin, Vito Grupposo, Nilarun Chowdhuri, Jennifer Maffre, Salman Farshchi-Heydari, Tushar Sharma, Christopher Beeckler and 6 more

Open access · hybridAbstract read
In one paragraph

Article in Circulation. Arrhythmia and electrophysiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
  2. Article
  3. Assessment of temperature dynamics in pulsed field ablation with a variable-loop circular catheter: a comparative analysis of waveform configurations and irrigation rates in specimens of bovine ventricular myocardium.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 · 2025
    Article
  4. Dual energy for pulmonary vein isolation using focal ablation technology integrated with a three-dimensional mapping system: SmartfIRE 12-month results.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 · 2025
    Article
  5. Article
  6. Article
  7. Application repetition and electrode-tissue contact result in deeper lesions using a pulsed-field ablation circular variable loop catheter.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 · 2024
    Article
  8. Review
  9. Dual energy for pulmonary vein isolation using dual-energy focal ablation technology integrated with a three-dimensional mapping system: SmartfIRE 3-month results.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 · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 6 institutions in 3 countries.

Luigi Di BiaseDivision of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).ORCID 0000-0001-6508-4047
Jacopo MarazzatoDivision of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).ORCID 0000-0003-1205-5925
Fengwei ZouDivision of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).ORCID 0000-0001-6355-8843
Aung LinDivision of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).
Vito GrupposoBiosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).ORCID 0009-0008-5130-1491
Nilarun ChowdhuriDivision of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).ORCID 0000-0001-6696-6367
Jennifer MaffreBiosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).ORCID 0000-0001-7582-8409
Salman Farshchi-HeydariBiosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
Tushar SharmaBiosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
Christopher BeecklerBiosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
Assaf GovariBiosense Webster, Irvine, CA/Yokne'am, Israel (V.G., J.M., S.F.-H., T.S., C.B., A.G.).
Rahul BhardwajLoma Linda University Medical Center (R.B.).ORCID 0000-0001-7734-8660
Sanghamitra MohantyTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (S.M., A.N.).ORCID 0000-0001-6601-944X
Andrea NataleTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin (S.M., A.N.).ORCID 0000-0002-5487-0728
Hiroshi NakagawaSection of Cardiac Electrophysiology & Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (H.N.).ORCID 0000-0001-9368-519X
Xiaodong ZhangDivision of Cardiology, Albert Einstein College of Medicine at Montefiore Health System, NY (L.D.B., J.M., F.Z., A.L., N.C., X.Z.).ORCID 0000-0002-2856-943X
Montefiore Health System · USBiosensores (Spain) · ESTexas Cardiac Arrhythmia · USBattery Park · USCleveland Clinic · USLoma Linda University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPulsed field ablation (PFA) has emerged as an alternative to radiofrequency ablation. However, data on focal point-by-point PFA are scarce. The aim of this study was to compare lesion durability and collateral damage between focally delivered unipolar/biphasic PFA versus radiofrequency in swine.

methodsEighteen swine were randomized to low-dose PFA, high-dose PFA, and radiofrequency using a multimodality generator. Radiofrequency delivered by market-available generator served as control group. A contact force-sensing catheter was used to focally deliver PFA/radiofrequency at the pulmonary veins and other predefined sites in the atria. Animals were remapped postprocedurally and 28 days postablation to test lesion durability followed by gross necroscopy and histology.

resultsAll targeted sites were successfully ablated (contact force value, 13.9±4.1 g). Follow-up remapping showed persistent pulmonary vein isolation in all animals (100%) with lesion durability at nonpulmonary vein sites proven in most (98%). Regardless of the energy source used, the lesion size was similar across the study groups. Transmurality was achieved in 95% of targeted sites and 100% at pulmonary veins. On histology, PFA animals showed more mature scar formation than their radiofrequency counterpart without myocardial necrosis or inflammation. Finally, no sign of collateral damage was observed in any of the groups.

conclusionsIn a randomized preclinical study, focally delivered unipolar/biphasic PFA guided by contact force values was associated with durable lesions on chronic remapping and with mature scar formation on histology without signs of collateral injury on necroscopy. Further studies are needed to investigate the long-term feasibility of this new approach to atrial fibrillation treatment.

Indexed as

Atrial FibrillationCatheter AblationPulmonary VeinsRadiofrequency AblationAnimalsCathetersCicatrixSwineTreatment Outcomeatrial fibrillationcatheter ablationelectroporationpulmonary veinswine

Identifiers

PMID37994554
PMCPMC10734778
OpenAlexW4388943911

What OpenQuestion holds

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Registered trials

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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.