| Title: | Intracardiac electrogram analysis may allow for prediction of lesion transmurality after pulsed field ablation of atria in a porcine model |
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| Authors: | ID Štublar, Jernej (Author)
ID Jarm, Tomaž (Author)
ID Mattison, Lars M. (Author)
ID Martin, Bryan D. (Author)
ID Schmidt, Megan M. (Author)
ID Jan, Matevž (Author)
ID Verma, Atul (Author)
ID Iaizzo, Paul A. (Author)
ID Sigg, Daniel C. (Author)
ID Miklavčič, Damijan (Author) |
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| Files: |  PDF - Presentation file, download (1,34 MB)
MD5: 1C878E656665FF028E224122F1B828C0
 URL - Source URL, visit https://www.sciencedirect.com/science/article/pii/S2666501824004124
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | 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. |
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| Keywords: | pulsed field ablation, atria porcine model, intracardiac electrograms, bipolar vs unipolar iEGM, frequency analysis, discrete wavelet transform, current of injury, lesion transmurality |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2025 |
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| Number of pages: | str. 350-361 |
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| Numbering: | Vol. 6, iss. 3 |
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| PID: | 20.500.12556/DiRROS-28945  |
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| UDC: | 602.621:616.1 |
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| ISSN on article: | 2666-5018 |
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| DOI: | 10.1016/j.hroo.2024.11.025 |
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| COBISS.SI-ID: | 230283779 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 26. 3. 2025;
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| Publication date in DiRROS: | 14.04.2026 |
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| Views: | 121 |
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| Downloads: | 69 |
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