PO-03-034 OUTCOMES OF A 3-MONTH MAPPING STUDY FOLLOWING PULMONARY VEIN ISOLATION USING A NOVEL SINGLE-SHOT PULSED FIELD ABLATION SYSTEM IN A PORCINE MODEL

Pulsed field ablation (PFA) is a non-thermal ablative strategy that achieves cell death via electroporation. We investigated the durability of PFA lesions using 2 novel PFA/mapping catheters (CRC EP Inc, San Jose, CA) at repeat studies performed 3 months post-ablation. In total, 16 pulsed applications were delivered in swine under general anesthesia absence paralytic agents, including: 1 application to left atrial appendage, 9 right pulmonary veins (PVs), inferior common PV and ventricle (RV). The design consists an 8-Fr, 16-electrode, bidirectional, 25-mm or 30-mm spiral, latter bearing distal pairs mapping electrodes active even during delivery. inserted through commercially available 8.5-Fr steerable introducer (Agilis, Abbott, Chicago, IL). Bipolar (>2 kV) was single-shot, QRS-gated 3D intracardiac echocardiographic guidance. Skeletal muscle activation intensity quantified accelerometer (Phyphox, Aachen, Germany). Lesions assessed by pre- versus post-EGM analysis, pacing threshold, voltage (EnSite, Abbott), necropsy, histology. All single-shot (34 ± 12 s) without repositioning catheter. Minimal microbubbling observed with mild no skeletal stimulation (acceleration <4 m/s2). No tachyarrhythmias induced PFA. Immediately post-ablation, bilateral isolation confirmed partial posterior wall coronary sinus (CS). Repeat validated complete lesion locations, once again illustrating isolation. However, there conduction recovery adjacent, non-ablated/non-targeted sites (e.g., CS). Accordingly, significant reduction 3-month post- pre-PFA EGMs (1.38 0.70 mV vs. 0.04 0.03 mV, P<0.0001) RV (1.6 1.3 0.2 0.1 P<0.05) marked increase thresholds (>20 mA <10 mA, P<0.001). contiguous measuring 26 8 x 18 6 mm transmural atria 38 14 28 5 deep RV. A catheter system can create large, ventricular vivo are completely durable months.