ArticleCirculation. Arrhythmia and electrophysiology2024
Ablating Myocardium Using Nanosecond Pulsed Electric Fields: Preclinical Assessment of Feasibility, Safety, and Durability.
Article in Circulation. Arrhythmia and electrophysiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Ventricular pulsed field ablation from bench to bedside: preclinical and clinical evidence from a systematic review and meta-analysis.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 · 2026Pooled it
- Efficacy and safety of pulsed field ablation and very high-power short-duration ablation for atrial fibrillation: a meta-analysis.Frontiers in cardiovascular medicine · 2026Pooled it
- Pulsed Field Ablation Therapy Parameters: Enhancing Lesion Depth While Reducing Musculoskeletal Stimulation and Thermal Response in an Irrigated Tip Catheter: A Comprehensive Study Using In Silico, In Vitro, and In Vivo Models.Circulation. Arrhythmia and electrophysiology · 2026Article
- Current and Emerging Energy Sources for Atrial Fibrillation Ablation: A Comparative Analysis of Clinical Efficacy, Safety, and Procedural Implementation.Journal of clinical medicine · 2026Review
- Latest Advances and Ongoing Challenges in Pulsed Field Ablation.Arrhythmia & electrophysiology review · 2026Review
- Controversy: pulsed field ablation is the standard technique for all the candidates for atrial fibrillation ablation.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 · 2025Review
- Nanosecond Pulsed Electric Fields (nsPEFs) for Precision Intracellular Oncotherapy: Recent Advances and Emerging Directions.International journal of molecular sciences · 2025Review
- Comparative study of nanosecond and microsecond pulsed field ablation for pulmonary vein isolation in preclinical models.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 · 2025Article
- Pulsed field ablation for atrial fibrillation: clinical applications and research advances.Frontiers in cardiovascular medicine · 2025Review
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnlike conventional microsecond pulsed electrical fields that primarily target the cell membranes, nanosecond pulses are thought to primarily electroporate intracellular organelles. We conducted a comprehensive preclinical assessment of catheter-based endocardial nanosecond pulsed field ablation in swine.
methodsA novel endocardial nanosecond pulsed field ablation system was evaluated in a total of 25 swine. Using either a low-dose (5-second duration) or high-dose (15-second duration) strategy, thoracic veins and discrete atrial and ventricular sites were ablated. Predetermined survival periods were <1 (n=1), ≈2 (n=7), ≈7 (n=6), 14 (n=2), or ≈28 (n=9) days, and venous isolation was assessed before euthanasia. Safety assessments included evaluation of esophageal effects, phrenic nerve function, and changes in venous caliber. All tissues were subject to careful gross pathological and histopathologic examination.
resultsAll (100%) veins (13 low-dose, 34 high-dose) were acutely isolated, and all reassessed veins (6 low-dose, 15 high-dose) were durably isolated. All examined vein lesions (10 low-dose, 22 high-dose) were transmural. Vein diameters (n=15) were not significantly changed. Of the animals assessed for phrenic palsy (n=9), 3 (33%) demonstrated only transient palsy. There were no differences between dosing strategies. Thirteen mitral isthmus lesions were analyzed, and all 13 (100%) were transmural (depth, 6.4±0.4 mm). Ventricular lesions were 14.7±4.5 mm wide and 7.1±1.3 mm deep, with high-dose lesions deeper than low-dose (7.9±1.2 versus 6.2±0.8 mm;
conclusionsA novel, endocardial nanosecond pulsed field ablation system provides acute and durable venous isolation and linear lesions. Transient phrenic injury and nontransmural esophageal lesions can occur with worst-case assessments suggesting limits to pulsed field ablation tissue selectivity and the need for dedicated assessments during clinical studies.
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