ArticleJournal of cardiovascular electrophysiology2024
Comparison of efficiency of PFA catheter designs by computer modeling.
Article in Journal of cardiovascular electrophysiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Practical guide on the use of the PulseSelect pulsed field ablation system for atrial fibrillation ablation procedures.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 · 2026Guideline
- Pulmonary vein isolation durability in a randomized trial comparing fluoroscopy-only vs. electroanatomic mapping strategies for pulmonary vein isolation with balloon-in-basket pulsed-field 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 · 2026Trial
- Ablation with the circular pulsed field ablation catheter: Tips & techniques for using the PulseSelect catheter.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
- Variable-loop circular vs. Pentaspline catheter: hemolysis outcomes in pulsed-field ablation procedures for atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Catheter Design Matters: Hemolysis and Renal Function after Pulsed Field Ablation with Balloon-in-Basket vs. Pentaspline Systems.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Circumstances and clinical significance of cardiac troponin T elevation following transvenous lead extraction.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2026Article
- Intravascular hemolysis after pulsed field ablation for atrial fibrillation: A comparative analysis of 3 systems.Heart rhythm O2 · 2026Article
- Overcoming the Challenges of Transmural Durable Lesions With PFA-Impact of Electrode Design and Contact Assessment.Pacing and clinical electrophysiology : PACE · 2026Review
- Differential inflammatory and myocardial biomarker response after pulsed field ablation for atrial fibrillation using balloon-in-basket vs pentaspline catheters.Heart rhythm O2 · 2025Article
- 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
- Severe Hemolysis After Moderate-Dose Pulsed Field Application (48 Pulses) for Atrial Fibrillation/Flutter: A Cautionary Tale.JACC. Case reports · 2025Article
- Biophysics and electrophysiology of pulsed field ablation in normal and infarcted porcine cardiac ventricular tissue.Scientific reports · 2024Article
- Comparison of efficiency of PFA catheter designs by computer modeling.Journal of cardiovascular electrophysiology · 2024Article
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Authors and funding
2 authors.
Funding
Abstract
introductionVarious catheter designs are appearing for Pulsed Field Ablation (PFA). It is unclear if they differ in terms of safety and efficiency. PFA studies have reported hemolysis, kidney injury, high troponin, among other side effects.
methodsUsing a CT-derived computer model, we compared catheter designs using two metrics: (1) efficiency: power delivered to an atrial wall target, expressed as a percent of total generator power; and (2) safety: electric current to achieve 90% transmurality (since more energy causes more collateral effects), as well as the corresponding electrode current density (ECD), a heat and bubble metric. The following catheter designs were compared: penta-spline basket, Nitinol spheres (focal 9 mm and large 1-shot), circular, balloon, and flex-circuit. Target was a 6 × 47 mm circumferential segment of atrial wall at LPV antrum. Transmurality was defined as percent of target having >600 volts per centimeter (V/cm) electric field needed for electroporation.
resultsEfficiency was 0.9, 1.4, 2.7, 5.9, 10, and 12% for the large 1-shot and 9 mm Nitinol spheres, penta-spline, circular, flex spline, and balloon catheters, respectively. Regarding safety, currents for 90% transmurality were 70, 39,36,12.5, 5.3, and 4 Amps for the same respective catheters, with less being safer. ECD was 124, 25, 74, 83, 41, and 31 A/cm
conclusionComputer models demonstrated a remarkable range in efficiency among catheters studied. Those having less atrial blood exposure had the highest efficiencies, with factors of up to 13X more efficiency compared to exposed ones. Higher efficiency designs have less collateral current and are safer. Confirmatory in-vivo studies are required.
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