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Effect of Contact Force on Pulsed Field Ablation Lesions in Porcine Cardiac Tissue
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  • Daniel C. Sigg,
  • Lars Mattison,
  • Atul Verma,
  • Khaldoun G. Tarakji,
  • Tobias Reichlin,
  • Gerhard Hindricks,
  • Kevin Sack L,
  • Birce Onal,
  • Megan M. Schmidt,
  • Damijan Miklavčič
Daniel C. Sigg
Medtronic Inc

Corresponding Author:daniel.c.sigg@medtronic.com

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Lars Mattison
Medtronic Inc
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Atul Verma
McGill University
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Khaldoun G. Tarakji
Medtronic Inc
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Tobias Reichlin
Inselspital Universitatsspital Bern Universitatsklinik fur Kardiologie
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Gerhard Hindricks
Universitat Leipzig Medizinische Fakultat
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Kevin Sack L
Medtronic Inc
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Birce Onal
Medtronic Inc
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Megan M. Schmidt
Medtronic Inc
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Damijan Miklavčič
University of Ljubljana Ljubljana Slovenia
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Abstract

Background: Contact force has been used to titrate lesion formation for radiofrequency ablation. Pulsed Field Ablation (PFA) is a field-based ablation technology for which limited evidence on the impact of contact force on lesion size is available. Methods: Porcine hearts (n=6) were perfused using a modified Langendorff set-up. A prototype focal PFA catheter attached to a force gauge was held perpendicular to the epicardium and lowered until contact was made. Contact force was recorded during each PFA delivery. Matured lesions were cross-sectioned, stained, and the lesion dimensions were measured. Numerical modeling of the catheter-tissue interface under different contact forces was performed to aid in the interpretation of our results and isolate effects of biomechanical tissue displacement. Results: A total of 82 lesions were evaluated with contact forces between 1.3 g and 48.6 g. Mean lesion depth was 4.8 ± 0.9 mm (standard deviation), mean lesion width was 9.1 ± 1.3 mm and mean lesion volume was 217.0. ± 96.6 mm 3. Linear regression curves showed an increase of only 0.01 mm in depth (Depth = 0.01*Contact Force + 4.37, R 2 = 0.06), 0.03 mm in width (Width = 0.03*Contact Force + 8.32, R 2 = 0.12) for each additional gram of contact force, and 2.20 mm 3 in volume (Volume = 2.20*Contact Force + 163, R 2 = 0.11). Numerical modeling found consistent trends with experimental mean values and shows tissue displacement alone is likely not a significant factor to formation of lesion depth. Conclusions: Increasing contact force using a bipolar, biphasic focal PFA system has minor effects on acute lesion dimensions in an isolated porcine heart model.
11 Oct 2022Submitted to Journal of Cardiovascular Electrophysiology
11 Oct 2022Submission Checks Completed
11 Oct 2022Assigned to Editor
17 Oct 2022Reviewer(s) Assigned
06 Nov 2022Review(s) Completed, Editorial Evaluation Pending
07 Nov 2022Editorial Decision: Revise Minor
24 Nov 20221st Revision Received
25 Nov 2022Assigned to Editor
25 Nov 2022Submission Checks Completed
25 Nov 2022Review(s) Completed, Editorial Evaluation Pending
25 Nov 2022Reviewer(s) Assigned
12 Dec 2022Editorial Decision: Revise Minor
12 Dec 20222nd Revision Received
14 Dec 2022Assigned to Editor
14 Dec 2022Review(s) Completed, Editorial Evaluation Pending
14 Dec 2022Submission Checks Completed
14 Dec 2022Reviewer(s) Assigned
27 Dec 2022Editorial Decision: Accept