Variability in Tissue Interface Temperature During Pulse Field Atrial Ablation: Implications for Real-Time Contact Assessment

BACKGROUND: Pulsed field ablation (PFA) can generate low-intensity catheter-tissue interface heating. Recently, a large-focal PFA catheter able to measure the tip-tissue interface temperature has become available. Accordingly, we aimed to characterize the electrode tip-tissue interface temperature dynamics during PFA. METHODS: A retrospective single-center study evaluated PFA lesions in 41 consecutive patients undergoing atrial fibrillation ablation using the lattice-tip catheter. Lesions were grouped by anatomic location with interface temperatures measured via catheter tip thermocouples. The association of predictors with lesion temperatures was evaluated with a mixed-effects model. An analysis of lesion dimensions and interface temperatures was also performed in swine. RESULTS: =0.007). CONCLUSIONS: Lattice-tip temperatures during PFA vary substantially, with right superior pulmonary vein sites often demonstrating a blunted temperature response compared with other sites. Peak and average temperatures correlated with lesion depth.