脉冲场消融指数引导的病变形成消融:心室模型中接触力和应用次数的影响

IF 9.1 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Circulation. Arrhythmia and electrophysiology Pub Date : 2024-04-01 Epub Date: 2024-02-23 DOI:10.1161/CIRCEP.123.012717
Luigi Di Biase, Jacopo Marazzato, Assaf Govari, Andreas Altman, Christopher Beeckler, Joe Keyes, Tushar Sharma, Vito Grupposo, Fengwei Zou, Masafumi Sugawara, Atsushi Ikeda, Farshad Raissi, Rahul Bhardwaj, Jonathan C Hsu, Mark Lee, Rajesh Banker, Sanghamitra Mohanty, Andrea Natale, Qi Chen, Paras Parikh, Xiaodong Zhang, Hiroshi Nakagawa
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引用次数: 0

摘要

背景:在脉冲场消融(PFA)过程中,接触力(CF)对病变形成的影响尚不明确。本研究旨在通过 PFA 指数(PF 指数)公式评估 CF、PFA 及其相互作用对猪心室病灶大小的影响:方法:通过CF感应OMNYPULSE导管输送PFA。在维持低(5-25 克)、高(26-50 克)和极高(51-80 克)CF 的情况下,使用预定义的 PFA 应用(×3、×6、×9 和×12)。首先,对 11 头猪的尸体解剖进行了 PFA 病变评估,以研究 CF/PFA 及其在 PF 指数方程中的整合对病变大小的影响(研究特征)。然后,在 6 头猪身上测试了 3 种不同的 PF 指数阈值--300、450 和 600,以评估 PF 指数预测心室病变深度的准确性(研究验证):在研究特征数据集中,分析了 111 个 PFA 病变。平均病变深度和宽度分别为 3.5±1.2 mm 和 12.0±3.5 mm。与单独的 CF 和 PFA 剂量相比,它们的共同作用通过渐近递增关系影响了病变深度。同样,在研究验证数据集中,PF 指数不仅与病变深度相关(r2=0.66;PConclusions:CF和PFA的应用在PFA过程中的病变形成中起着关键作用。需要进一步的研究来评估实现透壁病变的最佳 PFA 消融设置。
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Pulsed Field Ablation Index-Guided Ablation for Lesion Formation: Impact of Contact Force and Number of Applications in the Ventricular Model.

Background: The effect of contact force (CF) on lesion formation is not clear during pulsed field ablation (PFA). The aim of this study was to evaluate the impact of CF, PFA, and their interplay through the PFA index (PF index) formula on the ventricular lesion size in swine.

Methods: PFA was delivered through the CF-sensing OMNYPULSE catheter. Predefined PFA applications (×3, ×6, ×9, and ×12) were delivered maintaining low (5-25 g), high (26-50 g), and very high (51-80 g) CFs. First, PFA lesions were evaluated on necropsy in 11 swine to investigate the impact of CF/PFA-and their integration in the PF index equation-on lesion size (study characterization). Then, 3 different PF index thresholds-300, 450, and 600-were tested in 6 swine to appraise the PF index accuracy to predict the ventricular lesion depth (study validation).

Results: In the study characterization data set, 111 PFA lesions were analyzed. CF was 32±17 g. The average lesion depth and width were 3.5±1.2 and 12.0±3.5 mm, respectively. More than CF and PFA dose alone, it was their combined effect to impact lesion depth through an asymptotically increasing relationship. Likewise, not only was the PF index related to lesion depth in the study validation data set (r2=0.66; P<0.001) but it also provided a prediction accuracy of the observed depth of ±2 mm in 69/73 lesions (95%).

Conclusions: CF and PFA applications play a key role in lesion formation during PFA. Further studies are required to evaluate the best PFA ablation settings to achieve transmural lesions.

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来源期刊
CiteScore
13.70
自引率
4.80%
发文量
187
审稿时长
4-8 weeks
期刊介绍: Circulation: Arrhythmia and Electrophysiology is a journal dedicated to the study and application of clinical cardiac electrophysiology. It covers a wide range of topics including the diagnosis and treatment of cardiac arrhythmias, as well as research in this field. The journal accepts various types of studies, including observational research, clinical trials, epidemiological studies, and advancements in translational research.
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