AB-452672-2 ULTRA-LOW TEMPERATURE CRYOABLATION VERSUS ULTRA-LOW TEMPERATURE CRYOABLATION COMBINED WITH PULSED FIELD ABLATION IN A SWINE VENTRICULAR INFARCT MODEL

Treatment of ventricular arrhythmias with radiofrequency (RF) catheter ablation can be limited by insufficient lesion size and depth, especially within diseased myocardium. A recent investigation using a force-sensing RF (30 watts / 30 seconds) described average depths 5.1 mm healthy tissue 2.0 scar. To compare measurements ultra-low temperature cryoablation (ULTC) versus pulsed field (ULTC combined ablation, PFCA) in both infarcted myocardium an in-vivo swine model. An anterior infarct was created three 120 minute left descending balloon occlusion. After one month, endocardial lesions were placed the ventricle linear, deflectable (Figure, Panel A) capable delivering ULTC or PFCA (Adagio Medical, Irvine, CA). The system utilizes pressurized nitrogen at -196 degrees C to deliver lesions. Electroanatomic mapping used differentiate from ensure non-overlapping One animal received only (freeze-thaw-freeze each site, freezes two minutes) animals (single two-minute freeze 4kV biphasic, bipolar PFA pulses delivered during freeze). Animals euthanized after delivery gross performed. total 8 15 delivered. Lesion slightly larger compared tissue, although all clinically substantial B). While there no significant difference median between Panels D), resulted significantly more transmural scar alone (67% 0%, p = 0.02). In total, 35% transmural. Maximal single depth 17 20.5 PFCA, respectively. width 22 for PFCA. Ultra-low Addition allowed time per halved without change size.