{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:09:28Z","timestamp":1792642168446,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Various catheter designs are appearing for Pulsed Field Ablation (PFA). It is unclear if they differ in terms of safety and efficiency. PFA studies have reported hemolysis, kidney injury, high troponin, among other side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a CT\u2010derived computer model, we compared catheter designs using two metrics: (1) efficiency: power delivered to an atrial wall target, expressed as a percent of total generator power; and (2) safety: electric current to achieve 90% transmurality (since more energy causes more collateral effects), as well as the corresponding electrode current density (ECD), a heat and bubble metric. The following catheter designs were compared: penta\u2010spline basket, Nitinol spheres (focal 9\u2009mm and large 1\u2010shot), circular, balloon, and flex\u2010circuit. Target was a 6\u2009\u00d7\u200947\u2009mm circumferential segment of atrial wall at LPV antrum. Transmurality was defined as percent of target having &gt;600 volts per centimeter (V\/cm) electric field needed for electroporation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Efficiency was 0.9, 1.4, 2.7, 5.9, 10, and 12% for the large 1\u2010shot and 9\u2009mm Nitinol spheres, penta\u2010spline, circular, flex spline, and balloon catheters, respectively. Regarding safety, currents for 90% transmurality were 70, 39,36,12.5, 5.3, and 4\u2009Amps for the same respective catheters, with less being safer. ECD was 124, 25, 74, 83, 41, and 31\u2009A\/cm<jats:sup>2<\/jats:sup>, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Computer models demonstrated a remarkable range in efficiency among catheters studied. Those having less atrial blood exposure had the highest efficiencies, with factors of up to 13X more efficiency compared to exposed ones. Higher efficiency designs have less collateral current and are safer. Confirmatory in\u2010vivo studies are required.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16459","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T16:12:03Z","timestamp":1728403923000},"page":"2382-2393","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Comparison of efficiency of PFA catheter designs by computer modeling"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4190-7306","authenticated-orcid":false,"given":"Andres","family":"Belalcazar","sequence":"first","affiliation":[{"name":"Biophysicist Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Kevin","family":"Heist","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Service Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.121.010086"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2021.07.006"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.008716"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2023.12.008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2023.11.001"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2021.10.004"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad030"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2023.01.009"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2022.03.519"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-03895-2_18"},{"key":"e_1_2_8_12_1","unstructured":"US Patent 10 842 561B2. Systems devices and methods for delivery of pulsed electric field ablative energy to endocardial tissue. Viswanathan R et al. Accessed at Google Patents or at US patent office. Description of figure 32A was used."},{"key":"e_1_2_8_13_1","unstructured":"Prague Rhythm 2022 Conference April 25 Live demonstrations II \u2013 AF ablation \u2010 Part B. Case 5: PVI using single shot pulsed field ablation. The aborted delivery is at time 10:48 of the video Accessedhttps:\/\/www.youtube.com\/watch?v=9K2IBlUOebk"},{"key":"e_1_2_8_14_1","unstructured":"Boston Scientific 2023 educational video access athttps:\/\/educare.bostonscientific.eu then search for \u201cHow does the Farapulse PFA system and Farawave catheter work?\u201d see the bipolar description at the 35:00 time mark of the video."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.008580"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2019.12.015"},{"key":"e_1_2_8_17_1","unstructured":"US Design Patent D864 387 S. Catheter Tip with Openings.HarlevDandWallaceAM. Accessed at Google Patents or at US patent office."},{"key":"e_1_2_8_18_1","unstructured":"US Patent Application US2023\/0012307 A1 published Jan 12 2023. Serial number 17\/757 359. Pulmonary Vein Isolation Catheters and Devices Systems and Methods.HarlevDet al. Accessed at Google Patents or at US patent office."},{"key":"e_1_2_8_19_1","unstructured":"Heart Rhythm Society Dec 8 2022. Webinar accessible atheartrhythm365.org search for The Beat Webinar Series Episode: Pulsed Field Ablation \u2013 a shift in technology? In that Webinar the video of the large 1\u2010shot catheter arcing and bubbling in saline is shown at the 6:20 time mark by Dr Amin Al\u2010Ahmad."},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1160231"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.4149\/gpb_2015047"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.121.010375"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307291"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.063988"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.119.007781"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.008337"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.009229"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.07.032"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12608"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.112.973461"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2016.10.016"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2018.09.029"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2023.02.006"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2023.08.009"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2022.05.009"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2022.07.014"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16459","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T05:35:32Z","timestamp":1744349732000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.16459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,8]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/jce.16459"],"URL":"https:\/\/doi.org\/10.1111\/jce.16459","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,8]]},"assertion":[{"value":"2024-07-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}