Understanding Pulse Field Ablation: Insights from Biophysics and Preclinical Studies-Understanding Pulse Field Ablation: Insights from Biophysics and Preclinical Studies

Video Transcription

Video Summary

The session discussed recent advancements and challenges with pulse field ablation (PFA) technology in treating atrial arrhythmias, focusing on coronary artery spasm and injuries. Presenters highlighted the risk of coronary artery spasm when PFA is applied near coronary arteries, leading to potential complications like ventricular fibrillation. Various studies outlined the effectiveness of nitroglycerin in reducing but not fully preventing spasms, while cryoablation might offer mitigation benefits.<br /><br />The discussion also explored the potential advantages of combining ultra-low temperature cryo with PFA to minimize coronary injury, with studies using different catheter forms and mapping systems for enhanced accuracy in ablation procedures. A novel PFA ablation index was introduced to predict lesion depths, showcasing high accuracy despite recognizing that contact force significantly influences lesion formation.<br /><br />The impact of monopolar and bipolar PFA and RF on coronary artery injury was examined, revealing that PFA can cause similar injury to RF. Despite claims of subclinical injuries being common, acute effects like coronary spasm remain a significant concern. The session concluded with discussions on the potential of dual-energy catheters to mitigate these risks, acknowledging the need for improved technology to safely manage close proximities to coronary arteries during ablations.

Keywords

pulse field ablation

atrial arrhythmias

coronary artery spasm

ventricular fibrillation

nitroglycerin

cryoablation

ablation index

monopolar and bipolar PFA

dual-energy catheters