20.500.12556/DiRROS-28945 Intracardiac electrogram analysis may allow for prediction of lesion transmurality after pulsed field ablation of atria in a porcine model Background Pulsed field ablation (PFA) is a novel cardiac ablation modality with an increasing clinical acceptance in treatment of atrial fibrillation due to its clinical efficacy and excellent safety profile. However, intraprocedural guidance for PFA to ensure durable pulmonary vein isolation (PVI) is lacking. Objective We quantified changes in intracardiac electrograms (iEGMs) following PFA and radiofrequency ablation (RFA) and investigated their applicability for prediction of lesion transmurality. Methods We induced 38 atrial lesions using PFA or RFA in 5 swine and monitored iEGMs continuously for up to 30 minutes postablation. The most characteristic changes in iEGMs were quantified after the decomposition using discrete wavelet transform, which allowed us to analyze the effects in separate frequency bandwidths. Results After the ablation, we observed a reduction of bipolar iEGM amplitude (for PFA and RFA) and an increase in unipolar iEGM amplitude (predominantly for PFA). These changes were due to 2 mechanisms with different frequency content. The low-frequency content of unipolar iEGMs (1–16 Hz) further enabled us to discriminate between transmural and nontransmural lesions in the case of PFA. The rate of reduction of initially increased current-of-injury effect reflected in the low-frequency content of unipolar iEGMs within the first few minutes postablation was significantly higher and more pronounced for nontransmural lesions. Conclusion This study shows that unipolar iEGMs can be used to differentiate between transmural and nontransmural atrial lesions within minutes after PFA in a porcine model, with implications for development of intraprocedural guidance of PFA procedures. pulsed field ablation atria porcine model intracardiac electrograms bipolar vs unipolar iEGM frequency analysis discrete wavelet transform current of injury lesion transmurality srčna ablacija z ireverzibilno elektroporacijo srčni preddvor v prašičjem modelu znotrajsrčni elektrogrami bipolarni in unipolarni iEGM frekvenčna analiza diskretna valčna transformacija tok poškodbe transmularnost lezije true false true Angleški jezik Slovenski jezik Neznano 2026-04-14 12:40:14 2026-04-14 12:40:14 2026-04-15 03:57:38 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 26. 3. 2025; str. 350-361 iss. 3 Vol. 6 Mar. 2025 0000-00-00 Zaloznikova Objavljeno apc 0000-00-00 0000-00-00 0000-00-00 602.621:616.1 2666-5018 10.1016/j.hroo.2024.11.025 230283779 RAZ_Stublar_Jernej_2025.pdf RAZ_Stublar_Jernej_2025.pdf 1 1C878E656665FF028E224122F1B828C0 d2e0241f1eb78e01e8eccde1e72f77b094870f0a018677a8187a3af24ccbd04c 6e4e3c00-37ee-11f1-9cc3-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=43175 https://www.sciencedirect.com/science/article/pii/S2666501824004124 1 55b55695-37ee-11f1-9cc3-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=43174 Univerzitetni klinični center Ljubljana 0 0 0