Arrhythmogenicity of monophasic and biphasic PFA waveforms in a porcine model.

Objective: The potential risk of inducing ventricular arrhythmias was explored by employing pulsed field ablation (PFA) through the administration of both monophasic and biphasic waveform deliveries.

Methods: PFA was applied to specific locations in the right ventricle (RV, n = 5 sites) in swine (n = 2), utilizing identical settings with consistent amplitude, pulse width, and a number of pulses for both monophasic and biphasic waveforms. PFA deliveries were precisely timed in 10-ms intervals across the entire T wave.

Results: Using monophasic waveforms, ventricular fibrillation (VF) was induced 7/7 times when PFA pulses were delivered during the T wave. Biphasic waveforms resulted in no ventricular arrhythmias when PFA was delivered across the entire duration of T wave.

Conclusions: Our findings indicate that VF can be consistently induced with monophasic pulse waveforms, but not with biphasic pulse waveforms in a porcine model.