B-PO02-179 IN VITRO EVALUATION OF DUAL-CATHETER HIGH-VOLTAGE ENDO-EPICARDIAL ELECTROPORATION

Abstract

Single-catheter electroporation can be limited by muscle contractions associated with current delivery through the skin. An impedance mismatch between dispersive skin electrodes and intracardiac electroporation catheter may require extraordinary efforts to balance such impulses. Data on the use of dual-catheter electroporation for cardiac ablation is lacking. To investigate feasibility of dual-catheter electroporation system. In vitro study was performed in a saline bath. A customized 20x1mm-electrode catheter was introduced in the veal heart endocardium. A second catheter (20x1mm-electrode, 10x2mm-electrode or 10x1mm-electrode) was located at adjacent epicardial sites. Biphasic impulses (6J, 50J, 100J, 150J, 200J each) were delivered between two catheters. Three configurations were investigated. Configuration using two spiral 20x1mm-electrode catheters delivered highest energy (150J) without audible pops (vs 100J/10x2mm and 50J/10x1mm). Impedance was higher at symmetrical configuration when compared to asymmetrical (20x1mm vs 10x2mm, 72±3Ω vs 63±2Ω, p=0,04; 20x1mm vs 10x1mm, 72±3Ω vs 59±1Ω, p=0,002). There was no difference between targeted and effective energies (p=0.96). No post-impulse signs of myocardial injury were found. Endo-epicardial electroporation at the threshold audible pop is not associated with visible myocardial injury. Symmetrical catheter configuration is associated with highest capability of pulse delivery and highest system impedance. In vivo studies are warranted to determine safety and efficacy.