Computational modeling of Pulsed Field Ablation for pulmonary vein isolation

TL;DR

This study develops a patient-specific 3D computational model to analyze pulsed field ablation for pulmonary vein isolation, validating its accuracy and comparing different catheter designs to optimize treatment strategies.

Contribution

It introduces a validated, patient-specific computational framework for simulating pulsed field ablation, enabling detailed analysis of catheter performance and lesion formation.

Findings

Circular catheters are more energy-efficient at lower voltages.

Basket catheters produce larger lesions.

Model accurately predicts lesion characteristics across scenarios.

Abstract

Pulsed field ablation (PFA) has emerged as a non-thermal alternative to traditional thermal ablation techniques for the treatment of atrial fibrillation (AF). This study presents a patient-specific 3D computational framework to model the effects of PFA on pulmonary vein isolation (PVI). The modeling framework is rigorously validated against published numerical and experimental data, demonstrating strong agreement across a range of scenarios. Using realistic left atrial (LA) anatomy, commercially available circular, flower, and basket catheter configurations are simulated to evaluate lesion formation across different applied voltages. The performance of each catheter type is quantitatively assessed using multiple metrics, including lesion volume, energy delivery efficiency and transmurality. Simulation results show that circular catheters provide the highest energy delivery efficiency and target coverage at lower voltages, while basket catheters produce the largest lesion volumes. This framework offers a useful basis for exploring catheter design and treatment planning in PFA applications.