Arrhythmogenicity of monophasic and biphasic PFA waveforms in a porcine model

J Cardiovasc Electrophysiol. 2024 Dec;35(12):2487-2490. doi: 10.1111/jce.16480. Epub 2024 Nov 3.

Abstract

Objective: The potential risk of inducing ventricular arrhythmias was explored by employing pulsed field ablation (PFA) through the administration of both monophasic and biphasic waveform deliveries.

Methods: PFA was applied to specific locations in the right ventricle (RV, n = 5 sites) in swine (n = 2), utilizing identical settings with consistent amplitude, pulse width, and a number of pulses for both monophasic and biphasic waveforms. PFA deliveries were precisely timed in 10-ms intervals across the entire T wave.

Results: Using monophasic waveforms, ventricular fibrillation (VF) was induced 7/7 times when PFA pulses were delivered during the T wave. Biphasic waveforms resulted in no ventricular arrhythmias when PFA was delivered across the entire duration of T wave.

Conclusions: Our findings indicate that VF can be consistently induced with monophasic pulse waveforms, but not with biphasic pulse waveforms in a porcine model.

Keywords: R‐wave gating; arrhythmia; electroporation; pulsed field ablation.

Publication types

  • Comparative Study

MeSH terms

  • Action Potentials*
  • Animals
  • Disease Models, Animal
  • Electrocardiography
  • Heart Rate*
  • Sus scrofa
  • Swine
  • Time Factors
  • Ventricular Fibrillation* / diagnosis
  • Ventricular Fibrillation* / etiology
  • Ventricular Fibrillation* / physiopathology

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