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.