Ablation System
An 8.5Fr, bi-directional, irrigated catheter (6mL/min) with a 10mm diameter spheroid tip comprised of 10 nitinol composite splines(Figure 1A) was connected to an investigational PEF system consisting of a generator and connection box (Figure 1B)(Galvanize Therapeutics; Redwood City, CA). The system is designed to create large focal lesions (Figure 1C) that reduce the number of applications required to create a typical lesion set. Monopolar PEF energy is delivered asynchronously using a proprietary biphasic waveform (25A,1.6ms) that minimizes microbubble formation and muscle contraction. The system measures LI between each spline and a central ring electrode. LI information is displayed using a graphical representation of the catheter tip where a color and bar length changes represent increasing impedance on each spline (Figure 1D ). The system is compatible with multiple EAM systems and is capable of creating electroanatomic maps of the heart and monitoring local electrograms (Figure 1E ).