250Efficacy of multi-electrode linear irreversible electroporation. (18th June 2020)

• Record Type: Journal Article
• Authors: Buist, T J; Groen, M H A; Wittkampf, F H M; Loh, K P; Doevendans, P A; Van Es, R; Elvan, A
• Is Part Of: Europace. Volume 22(2020)Supplement 1
• Publication Date: 2020-06-18
• Subjects: Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/euaa162.160
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract: Background: We investigated the efficacy of linear irreversible electroporation (IRE) ablation in a porcine model. Methods: The study was performed in 6 pigs (weight 60-75kg). After median sternotomy and opening of the pericardium, a pericardial cradle was formed and filled with blood. A linear 7 polar 7F electrode catheter with 2.5mm electrodes and 2.5mm inter-electrode spacing was placed in good epicardial contact. A single IRE application was delivered using 50 Joules (J) at 1 site and 100 J at 2 other sites, in random sequence, using a standard monophasic defibrillator connected to all 7 electrodes connected in parallel. The pericardium and thorax were closed and after 3 weeks survival animals were euthanized. 82 histological sections from all 18 electroporation lesions were analyzed. Results: A total of seven 50 J and fourteen 100 J epicardial IRE applications were performed. Mean peak voltages at 50 J and 100 J were 1079.2 V ± 81.1 and 1609.5 V ± 56.8, with a mean peak current of 15.4 A ± 2.3 and 20.2 A ± 1.7, respectively. Median depth of the 50J and 100J lesions were 3.2 mm (interquartile range [IQR], 3.1 – 3.6) and 5.5 mm (IQR, 4.6 – 6.6) (P < 0.001), respectively. Median lesion width of the 50J and 100J lesions were 3.9 mm (IQR, 3.7 – 4.8) and 5.4 mm (IQR, 5.0 - 6.3), respectively(P < 0.001). Longitudinal sections showed continuous lesions for 100J lesions. Conclusion: Epicardial linear application of IRE pulses is effective in creating continuous deep lesions.