B-PO04-124 EFFECTS OF PULSED ELECTRIC FIELDS ON THE CORONARY VASCULATURE IN SWINE

Abstract

Previous animal studies suggest a lack of significant injury to the vasculature following pulsed electric field (PEF) ablation. We sought to assess the effects of PEF on the coronary arteries in swine. We performed PEF ablations in pigs pretreated with dual antiplatelet and antiarrhythmic therapy. PEF was intracoronary using MapiT catheters (Biotronik, Berlin, Germany) or peri-coronary after epicardial access using EPT catheters (Boston Scientific, MA). PEF pulse duration was microsecond (Nanoknife 3.0, Angio Dynamics, NY) or nanosecond (CellFX, Pulse Biosciences, CA). We performed 39 intracoronary ablations in 10 pigs and 20 epicardial ablations in 4 pigs. PEF was delivered at an energy level of 23 (quartile range [QR 10-64]) J with 100 microsecond pulses in 10 ablations and 300 nanosecond pulses in 49 ablations. We observed reversible coronary spasm in 15 of 39 intracoronary ablations and 9 of 20 epicardial ablations. At the end study at 17 (QR 0-35) days, angiographic stenosis was seen with 17 of 39 intracoronary ablations and 0 of 20 epicardial ablations. Gross pathology lesions were observed in 27 (47%) lesions. Histopathology was performed for 13 lesions. In 10 of 13 lesions ablative changes were seen in the ventricular myocardium with median maximal diameter 14 (QR 5-19) mm and maximal lesion area 40 (QR 5-118) mm2. Coronary injury on pathology was seen in 2 of 4 intracoronary ablations and 0 of 9 epicardial ablations (Figure 1). In the swine model reversible coronary spasm was seen with both intracoronary and peri-coronary PEF. However, angiographic or histopathologic stenosis at the end study was observed only with intracoronary PEF.