Atrial and ventricular Pulsed field ablation in a porcine animal model, correlated with clinical biomolecule data: Tissue specificity and lesion formation over 8 weeks

• Applicant: Dr. Moritz Nies
• Subject Area: Cardiology, Angiology
• Term: since 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 523496205

The role of catheter ablation for the treatment of cardiac arrhythmias continues to grow in clinical practice. Myocardial tissue propagating arrhythmias is localized and destroyed in a controlled, targeted way. Pulsed-field ablation (PFA) is a new type of catheter ablation, in which strong electrical fields are applied to induce micropores in cell membranes of the targeted tissue. This mechanism is called electroporation. The resulting cell death resembles the processes known from apoptosis. As the susceptibility for PFA is cell-type specific, selectively ablating myocardial cells while sparing non-myocardial tissue is achievable. These aspects are major advantages of PFA over conventional ablation techniques that use thermal energy to induce coagulation necrosis of the targeted tissue. This necrosis usually triggers a strong inflammatory reaction. Thermal energy spreads from the point of application irrespective of the tissue subtype, frequently resulting in damage to non-myocardial structures such as neurons or blood vessels. So far, PFA is only approved for catheter ablation of atrial fibrillation. Atrial and ventricular myocardium differ significantly, e.g. in their anatomical structure, wall thickness and autonomic innervation. It is an important research objective to facilitate the application of PFA for ventricular arrhythmias. This will make the advantages of this new modality accessible for an even larger group of patients. In the proposed study, atrial and ventricular ablation lesions will be created in n=20 swine, using PFA or thermal (radiofrequency current) ablation. After different periods post-ablation, inflammatory reactions, lesion formation and damage to non-myocardial structures will be assessed using cardiac MRI, biomolecule analyses and histopathology. The results of the proposed study will deepen our understanding of PFA in comparison to conventional catheter ablation. This is especially true for the application in ventricular myocardium, which has not been studied extensively yet. The data of biomolecule analyses acquired in our animal study will be validated on an already established clinical cohort. This connection of experimental and clinical data offers a huge translational potential.

• DFG Programme: WBP Fellowship
• International Connection: USA
• Host: Professor Dr. Vivek Reddy