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. 2023 Sep;9(9):1854-1863.
doi: 10.1016/j.jacep.2023.05.005. Epub 2023 Jul 19.

Thermal Profiles for Focal Pulsed Electric Field Ablation

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Free article

Thermal Profiles for Focal Pulsed Electric Field Ablation

Atul Verma et al. JACC Clin Electrophysiol. 2023 Sep.
Free article

Abstract

Background: Pulsed electrical field (PEF) ablation may cause tissue heating. These changes are reportedly small, but each PEF system and waveform will have a different behavior, and data are lacking.

Objectives: This study sought to compare the temperature profile of focal point, monopolar biphasic PEF ablation versus radiofrequency (RF).

Methods: Ablation lesions were performed on perfused thigh muscle of swine. PEF lesions were performed with 3 compatible ablation catheters at the highest (25 amp) energy, and 1 catheter (Tacticath SE) was also used at the 22- and 19-amp levels. Temperature changes in the tissue were measured using fluoroptic temperature probes inserted at the muscle surface, as well as 3 mm and 7 mm below the surface. Temperatures were recorded continuously at baseline, during delivery, and after ablation. Muscle temperatures were compared with those of RF lesions performed with 1 catheter (Tacticath SE) at 30 W for 30 seconds.

Results: PEF ablation with 3energy settings produced small temperature changes. Maximum average temperature rise for PEF for the maximum (25-amp) energy setting (32 lesions) was 7.6 °C, 2.8 °C, and 0.9 °C at the surface, 3-mm depth, and 7-mm depth, respectively. The temperature rise was dose dependent, with lower energy settings yielding less temperature rise. RF ablations (10 lesions) produced temperature increases of 16.6 °C, 39.8 °C, and 9.5 °C at the surface, 3-mm depth, and 7-mm depth, respectively.

Conclusions: PEF caused detectable temperature changes in muscle tissue, which never exceeded 2.8 °C at the 3-mm depth versus baseline. By contrast, RF produced substantial temperature rises. These data support that focal monopolar biphasic energy delivered by this PEF technology retains a favorable thermal safety profile.

Keywords: CENTAURI; ablation; cardiac; profile; pulsed electrical fields; temperature.

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Conflict of interest statement

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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