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)...

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Autores: Petras, A.|||0000-0002-3278-620X, Amorós Figueras, Gerard|||0000-0002-2109-5550, Moreno Weidmann, Zoraida|||0000-0003-1071-4077, García Sánchez, Tomás, Viladés Medel, David|||0000-0002-3638-9703, Ivorra, A., Guerra Ramos, José María|||0000-0001-5397-9177, Gerardo-Giorda, L.|||0000-0001-8467-1247
Tipo de documento: artigo
Data de publicação:2025
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:ddd.uab.cat:322731
Acesso em linha:https://ddd.uab.cat/record/322731
https://dx.doi.org/urn:doi:10.1016/j.hroo.2025.02.014
Access Level:Acceso aberto
Palavra-chave:Cardiac ablation
Computer simulations
Electric field threshold
Mathematical modeling
Pulsed field ablation
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spelling Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation?Petras, A.|||0000-0002-3278-620XAmorós Figueras, Gerard|||0000-0002-2109-5550Moreno Weidmann, Zoraida|||0000-0003-1071-4077García Sánchez, TomásViladés Medel, David|||0000-0002-3638-9703Ivorra, A.Guerra Ramos, José María|||0000-0001-5397-9177Gerardo-Giorda, L.|||0000-0001-8467-1247Cardiac ablationComputer simulationsElectric field thresholdMathematical modelingPulsed field ablationBackground: 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.Universitat Autònoma de Barcelona. Departament de Medicina 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/322731https://dx.doi.org/urn:doi:10.1016/j.hroo.2025.02.014reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3227312026-06-06T12:50:31Z
dc.title.none.fl_str_mv Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation?
title Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation?
spellingShingle Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation?
Petras, A.|||0000-0002-3278-620X
Cardiac ablation
Computer simulations
Electric field threshold
Mathematical modeling
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_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_sort Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation?
dc.creator.none.fl_str_mv Petras, A.|||0000-0002-3278-620X
Amorós Figueras, Gerard|||0000-0002-2109-5550
Moreno Weidmann, Zoraida|||0000-0003-1071-4077
García Sánchez, Tomás
Viladés Medel, David|||0000-0002-3638-9703
Ivorra, A.
Guerra Ramos, José María|||0000-0001-5397-9177
Gerardo-Giorda, L.|||0000-0001-8467-1247
author Petras, A.|||0000-0002-3278-620X
author_facet Petras, A.|||0000-0002-3278-620X
Amorós Figueras, Gerard|||0000-0002-2109-5550
Moreno Weidmann, Zoraida|||0000-0003-1071-4077
García Sánchez, Tomás
Viladés Medel, David|||0000-0002-3638-9703
Ivorra, A.
Guerra Ramos, José María|||0000-0001-5397-9177
Gerardo-Giorda, L.|||0000-0001-8467-1247
author_role author
author2 Amorós Figueras, Gerard|||0000-0002-2109-5550
Moreno Weidmann, Zoraida|||0000-0003-1071-4077
García Sánchez, Tomás
Viladés Medel, David|||0000-0002-3638-9703
Ivorra, A.
Guerra Ramos, José María|||0000-0001-5397-9177
Gerardo-Giorda, L.|||0000-0001-8467-1247
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona. Departament de Medicina
dc.subject.none.fl_str_mv Cardiac ablation
Computer simulations
Electric field threshold
Mathematical modeling
Pulsed field ablation
topic Cardiac ablation
Computer simulations
Electric field threshold
Mathematical modeling
Pulsed field ablation
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.
publishDate 2025
dc.date.none.fl_str_mv 2
2025-01-01
2025
2025-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/322731
https://dx.doi.org/urn:doi:10.1016/j.hroo.2025.02.014
url https://ddd.uab.cat/record/322731
https://dx.doi.org/urn:doi:10.1016/j.hroo.2025.02.014
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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