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2020 AF Symposium Abstract

Durability of Pulsed Field Ablation Isolation Over Time: Preliminary Study

To better understand this report you should read it in conjunction with my report of Dr. Reddy’s pre-recorded video entitled, Pulsed Field Ablation (PFA) for AF.

This abstract, distributed at the AF Symposium, details a small preliminary study by researchers at Mount Sinai Hospital in New York. They investigated whether Pulsed Field Ablation (PFA) lesions last over time.

We know that Pulsed Field Ablation (PFA) makes safe and durable lesions around the Pulmonary Veins and it produces a zone of irreversible electroporation and cell death. We also know that surrounding this ablated area is a zone of reversible electroporation and cell injury that normalizes over time and turns back into normal tissue.

This study asked whether the level of electrical isolation after PFA regressed over time.

Comparing PFA Ablated Areas with Non-PFA Ablated Tissue

In this clinical trial, detailed voltage maps were created immediately after PFA and again after 3 months. They basically compared the areas of left- and right-sided PV antrum isolation with the non-ablated posterior wall area and, more importantly, with the borders between these two areas.

Results and Conclusion

After 3 months, the ablated areas remained isolated and the non-ablated areas stayed non-ablated. The distances between the borders remained the same.

The authors concluded that PFA isolation persists without regression.

Editor’s Comments:

Since Pulsed Field Ablation (PFA) is such a new treatment, the question of whether PFA electrical isolation regresses over time needed to be asked.

This small preliminary study confirms what we would expect. PFA isolation makes safe and durable lesions that lasts over time.

References for this article

Kawamura, I. et al. Do Pulsed Field Ablation Lesions Regress Over Time?―A Quantitative Analysis of the PVI Level of Isolation in the Acute and Chronic Settings. Ichan School of Medicine at Mount Sinai. AF Symposium 2020 brochure, Abstract AFS2020-54, p. 78.

Graphic source: Maor, Elad et al. Pulsed electric fields for cardiac ablation and beyond: A state-of-the-art review. Heart Rhythm, Volume 16, Issue 7, 1112 – 1120.

If you find any errors on this page, email us. Y Last updated: Wednesday, August 26, 2020