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Epicardial Pulsed Field Ablation of Ganglionated Plexi: Computational and Pre-Clinical Evaluation of a Bipolar Sub-Xiphoid Catheter for the Treatment of Atrial Fibrillation

Pre-Clinical
B O’Brien, J Reilly, K Coffey et al
Bioengineering 2024.
This paper presents electric field models and ablation studies for the prototype bipolar and subxiphoid device – both porcine and canine models were used. Acute extensions in atrial effective refractory period suggest that ablations efficacy is at least equivalent to the monopolar device that has already been used in open-chest clinical settings. Ablation of neuronal cells, within the epicardial ganglionated plexi, was confirmed through histology.

Establishing Irreversible Electroporation Electric Field Potential Threshold in A Suspension In Vitro Model for Cardiac and Neuronal Cells

In-Vitro Studies
S Avazzadeh, B O’Brien, K Coffey et al
Journal of Clinical Medicine 2021

This in-vitro cellular study explored the electroporation thresholds of neurons and cardiomyocytes in suspension. This is the first published data showing that the thresholds for both cell types are similar; the data for neuron cell bodies being much lower than published data on axons. This provides initial data towards understanding the mechanism of selective ablation of ganglionated plexi.

Establishing electroporation thresholds for targeted cell specific cardiac ablation in a 2D culture model

In-Vitro Studies
S Avazzadeh, MH Dehkordi, P Owens et al
J Cardiovasc Electrophysiol 2022.

This study of in-vitro electroporation assessed cultured layers of cardiomyocytes and neurons and showed that neurons have a slightly lower threshold compared to cardiomyocytes. In addition neurons showed continued cell death up to 24 hours after treatment, while cardiomyocytes trended towards low levels of recovery. This insight provides further understanding of how ganglionated plexi may be ablated and myocytes spared in an in vivo scenario.