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, Argyrios, Amorós Figueras, Gerard, Moreno Weidmann, Zoraida, García Sánchez, Tomás, Viladés-Medel, David, Ivorra Cano, Antoni, 1974-, Guerra, Jose M., Gerardo-Giorda, Luca
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:dnet:rdupf_______::eaf762c2ba8053b6673730b0b35c67f1
Acceso en línea:https://hdl.handle.net/10230/72833
http://dx.doi.org/10.1016/j.hroo.2025.02.014
Access Level:acceso abierto
Palabra clave:Cardiac ablation
Computer simulations
Pulsed field ablation
Electric field threshold
Mathematical modeling
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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, ArgyriosAmorós Figueras, GerardMoreno Weidmann, ZoraidaGarcía Sánchez, TomásViladés-Medel, DavidIvorra Cano, Antoni, 1974-Guerra, Jose M.Gerardo-Giorda, LucaCardiac ablationComputer simulationsPulsed field ablationElectric field thresholdMathematical modelingBackground: 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).Elsevier2026202620252026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/10230/72833http://dx.doi.org/10.1016/j.hroo.2025.02.014reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésHeart Rhythm O2. 2025;6(5):671-7info:eu-repo/grantAgreement/EC/H2020/892393info:eu-repo/grantAgreement/ES/2PE/PID2019-110120RB-I00© 2025 Heart Rhythm Society. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:dnet:rdupf_______::eaf762c2ba8053b6673730b0b35c67f12026-06-12T07:21:37Z
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, Argyrios
Cardiac ablation
Computer simulations
Pulsed field ablation
Electric field threshold
Mathematical modeling
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, Argyrios
Amorós Figueras, Gerard
Moreno Weidmann, Zoraida
García Sánchez, Tomás
Viladés-Medel, David
Ivorra Cano, Antoni, 1974-
Guerra, Jose M.
Gerardo-Giorda, Luca
author Petras, Argyrios
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
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
dc.subject.none.fl_str_mv Cardiac ablation
Computer simulations
Pulsed field ablation
Electric field threshold
Mathematical modeling
topic Cardiac ablation
Computer simulations
Pulsed field ablation
Electric field threshold
Mathematical modeling
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 2025
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/10230/72833
http://dx.doi.org/10.1016/j.hroo.2025.02.014
url https://hdl.handle.net/10230/72833
http://dx.doi.org/10.1016/j.hroo.2025.02.014
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Heart Rhythm O2. 2025;6(5):671-7
info:eu-repo/grantAgreement/EC/H2020/892393
info:eu-repo/grantAgreement/ES/2PE/PID2019-110120RB-I00
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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