Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation?
Background: Pulsed-field ablation (PFA) is a novel cardiac ablation technology based on irreversible electroporation (IRE). PFA computational models rely on identification of a lethal electric field threshold to predict the IRE area. However, the predicted lesion anisotropy ratios (width over depth)...
| Authors: | ; ; ; ; ; ; ; |
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| Format: | Article |
| Status: | Published version |
| Publication date: | 2025 |
| Country: | España |
| Institution: | Universitat Pompeu Fabra |
| Repository: | Repositorio Digital de la UPF |
| OAI Identifier: | oai:dnet:rdupf_______::eaf762c2ba8053b6673730b0b35c67f1 |
| Online Access: | https://hdl.handle.net/10230/72833 http://dx.doi.org/10.1016/j.hroo.2025.02.014 |
| Access Level: | Open access |
| Keyword: | Cardiac ablation Computer simulations Pulsed field ablation Electric field threshold Mathematical modeling |
| _version_ | 1878736925996613632 |
|---|---|
| author | Petras, Argyrios |
| author2 | Amorós Figueras, Gerard Moreno Weidmann, Zoraida García Sánchez, Tomás Viladés-Medel, David Ivorra Cano, Antoni, 1974- Guerra, Jose M. Gerardo-Giorda, Luca |
| author2_role | author author author author author author author |
| author_browse | Amorós Figueras, Gerard García Sánchez, Tomás Gerardo-Giorda, Luca Guerra, Jose M. Ivorra Cano, Antoni, 1974- Moreno Weidmann, Zoraida Petras, Argyrios Viladés-Medel, David |
| author_facet | Petras, Argyrios Amorós Figueras, Gerard Moreno Weidmann, Zoraida García Sánchez, Tomás Viladés-Medel, David Ivorra Cano, Antoni, 1974- Guerra, Jose M. Gerardo-Giorda, Luca |
| author_role | author |
| collection | Repositorio Digital de la UPF |
| description | Background: Pulsed-field ablation (PFA) is a novel cardiac ablation technology based on irreversible electroporation (IRE). PFA computational models rely on identification of a lethal electric field threshold to predict the IRE area. However, the predicted lesion anisotropy ratios (width over depth) vary extensively among recent studies, and these discrepancies remain a subject of discussion. Objective: This work aims to evaluate the predicted lesion anisotropy ratios using a PFA computational model by applying it to an open-chest in vivo porcine model geometry. Methods: Six domestic swine underwent epicardial PFA applications using a previously described waveform protocol. Animals were killed at least 3 hours after the last ablation, and lesions were assessed using triphenyltetrazolium chloride (TTC) staining. Numeric simulations were performed on a segmented and meshed porcine thoracic computed tomography (CT) scan, mimicking the open-chest experimental setup. Results: The maximum width of all simulated lesions was observed at the epicardial surface. The anisotropy ratios (AR) of the experimental lesions were smaller than the simulated ones (AR experimental vs simulated, 1.0-1.7 vs 2-2.7; Q1-Q3 quartiles). Increasing the peak voltage resulted in larger lesions; however, the computational model clearly underestimated the increase in lesion depth compared with the experimental data. Conclusion: Our computational model shows that a single lethal electric field threshold is insufficient to accurately predict both lesion depth and width in cardiac PFA. Our study suggests that for the given PFA waveforms, a threshold between 270 and 500 V/cm provides satisfactory lesion depth estimations, and a higher threshold between 790 and 1000 V/cm better captures the lesion width. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_97a9983ffed64da7c6dd00a1f0404859 |
| institution | Universitat Pompeu Fabra |
| instname_str | Universitat Pompeu Fabra |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:dnet:rdupf_______::eaf762c2ba8053b6673730b0b35c67f1 |
| publishDate | 2025 |
| publishDateSort | 2025 |
| publisher | Elsevier |
| publisherStr | Elsevier |
| reponame_str | Repositorio Digital de la UPF |
| spelling | Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation? Petras, Argyrios Amorós Figueras, Gerard Moreno Weidmann, Zoraida García Sánchez, Tomás Viladés-Medel, David Ivorra Cano, Antoni, 1974- Guerra, Jose M. Gerardo-Giorda, Luca Cardiac ablation Computer simulations Pulsed field ablation Electric field threshold Mathematical modeling Background: Pulsed-field ablation (PFA) is a novel cardiac ablation technology based on irreversible electroporation (IRE). PFA computational models rely on identification of a lethal electric field threshold to predict the IRE area. However, the predicted lesion anisotropy ratios (width over depth) vary extensively among recent studies, and these discrepancies remain a subject of discussion. Objective: This work aims to evaluate the predicted lesion anisotropy ratios using a PFA computational model by applying it to an open-chest in vivo porcine model geometry. Methods: Six domestic swine underwent epicardial PFA applications using a previously described waveform protocol. Animals were killed at least 3 hours after the last ablation, and lesions were assessed using triphenyltetrazolium chloride (TTC) staining. Numeric simulations were performed on a segmented and meshed porcine thoracic computed tomography (CT) scan, mimicking the open-chest experimental setup. Results: The maximum width of all simulated lesions was observed at the epicardial surface. The anisotropy ratios (AR) of the experimental lesions were smaller than the simulated ones (AR experimental vs simulated, 1.0-1.7 vs 2-2.7; Q1-Q3 quartiles). Increasing the peak voltage resulted in larger lesions; however, the computational model clearly underestimated the increase in lesion depth compared with the experimental data. Conclusion: Our computational model shows that a single lethal electric field threshold is insufficient to accurately predict both lesion depth and width in cardiac PFA. Our study suggests that for the given PFA waveforms, a threshold between 270 and 500 V/cm provides satisfactory lesion depth estimations, and a higher threshold between 790 and 1000 V/cm better captures the lesion width. A.P and L.GG acknowledge the partial support of the State of Upper Austria. The research was funded in part by the Austrian Science Fund (FWF) P35374N. For the purpose of Open Access, the author has applied a CC-BY public copyright license to any Author Accepted Manuscript (AAM) version arising from this submission. A.P acknowledges the FFG Bridge grant PFA-Mod. This work was partially supported by project (PID2019-110120RBI00 /AEI/10.13039/ 501100011033) from the Ministry of Science, Innovation and Universities and the State Research Agency of the Spanish government. This work was also partially supported by project ISCIII DTS20-00111 (Instituto de Salud Carlos III and cofunded by FEDER). This project has received funding from the European Union's Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement No 892393 (TACAIRE). Elsevier https://hdl.handle.net/10230/72833 http://dx.doi.org/10.1016/j.hroo.2025.02.014 |
| spellingShingle | Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation? Petras, Argyrios Cardiac ablation Computer simulations Pulsed field ablation Electric field threshold Mathematical modeling |
| status_str | publishedVersion |
| title | Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation? |
| title_full | Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation? |
| title_fullStr | Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation? |
| title_full_unstemmed | Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation? |
| title_short | Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation? |
| title_sort | Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation? |
| topic | Cardiac ablation Computer simulations Pulsed field ablation Electric field threshold Mathematical modeling |
| topic_facet | Cardiac ablation Computer simulations Pulsed field ablation Electric field threshold Mathematical modeling |
| url | https://hdl.handle.net/10230/72833 http://dx.doi.org/10.1016/j.hroo.2025.02.014 |