Atrial fibrillation and flutter conversion with pulsed electric field delivery: preclinical proof of concept.

Introduction: Device-based therapies for treating atrial fibrillation (AF) episodes are limited. Using pulsed electric fields (PEF) to induce reversible electroporation of cardiac tissue may effectively terminate AF. Thus, we aimed to assess the feasibility of PEF delivery for converting atrial arrhythmias via reversible electroporation.

Discrimination between RA and LA Sinus Rhythms using machine learning approach.

Atrial fibrillation (AF) is a common cardiac disease that potentially leads to fatal conditions. Machine Learning (ML) classification methods are widely used to distinguish between sinus rhythm and AF for post-ablation rhythms in ECG. However, intracardiac electrograms (iEGMs) recorded in the left atrium (LA) and right atrium (RA) might have different sinus rhythms characteristics.

Effects of In Vivo Contact Force on Pulsed-Field Ablation Efficacy in Porcine Ventricles.

Background: Pulsed-field ablation (PFA) is an innovative non-thermal method for arrhythmia treatment. The efficacy of various PFA configurations in relation to contact force (CF) has not been well-studied in vivo.

Objectives: This study evaluated the effect of CF on acute bipolar PFA lesions in both a vegetal and an in vivo porcine heart model.

Local calcium chloride infusion after pulsed field ablation enhances acute efficacy of cardiac electroporation.

Introduction: Pulsed field ablation (PFA) has emerged as an innovative therapy for cardiac arrhythmias. Drawing parallels with PFA's application in solid tumors, calcium chloride (CaCl) as an adjuvant therapy, known as calcium electroporation, may amplify PFA's apoptotic effects. We propose that PFA in the atrium could enhance calcium uptake through PFA-created pores, thereby increasing ablation efficacy even at reduced power levels by exploiting PFA's permeabilization effects.

Complexity analysis of electrical activity during endocardial and epicardial biventricular mapping of ventricular fibrillation.

Background: Ventricular fibrillation (VF) is a lethal cardiac arrhythmia that is a significant cause of sudden cardiac death. Comprehensive studies of spatiotemporal characteristics of VF in situ are difficult to perform with current mapping systems and catheter technology.

Objective: The goal of this study was to develop a computational approach to characterize VF using a commercially available technology in a large animal model.

Bipolar Electroporation Across the Interventricular Septum: Electrophysiological, Imaging, and Histopathological Characteristics.

Background: Pulsed electric field (PEF) ablation is an emerging modality for the treatment of cardiac arrhythmias. Data regarding effects on the interventricular septum are limited, and the optimal delivery protocol and electrode configuration remain undefined.

Objectives: This study sought to evaluate the electrophysiological, imaging, and histological characteristics of bipolar direct-current PEF delivered across the interventricular septum.

Open-chest Pulsed Electric Field Ablation of Cardiac Ganglionated Plexi in Acute Canine Models.

This study aimed to evaluate the safety and acute effect on markers of cardiac autonomic tone following pulsed electric fields (PEFs) delivered to epicardial ganglionated plexi (GP) during a cardiac surgical procedure. Ablation of GP as a treatment for atrial fibrillation (AF) has shown promise, but thermal ablation energy sources are limited by the risk of inadvertent collateral tissue injury. In acute canine experiments, median sternotomy was performed to facilitate the identification of 5 epicardial GP regions using an anatomy-guided approach.

Novel insights into the substrate involved in maintenance of ventricular fibrillation: results from continuous multipolar mapping in a canine model.

Background: While the triggers for ventricular fibrillation (VF) are well-known, the substrate required for its maintenance remains elusive. We have previously demonstrated dynamic spatiotemporal changes across VF from electrical induction of VF to asystole. Those data suggested that VF drivers seemed to reside in the distal RV and LV.

Ventricular nanosecond pulsed electric field delivery using active fixation leads: a proof-of-concept preclinical study.

Background: Mid-myocardial ventricular arrhythmias are challenging to treat. Cardiac electroporation via pulsed electric fields (PEFs) offers significant promise. We therefore tested PEF delivery using screw-in pacemaker leads as proof-of-concept.

Regional and Temporal Variation of Ventricular and Conduction Tissue Activity During Ventricular Fibrillation in Canines.

[Figure: see text].

Electroporation ablation of bronchial smooth muscle cells: A novel non-thermal asthma therapy.

Objective: Asthma is a common disease which places significant burden on the US healthcare system and which can be associated with significant patient morbidity and mortality. Current medical therapies are costly and not curative. A new approach for a more permanent asthma treatment is the use of radiofrequency ablation.