Left Atrial Ablation: Unlocking Preclinical Potential

Large animal models, particularly pigs ??, are essential for advancing left atrial ablation therapies. Understanding their unique anatomical characteristics is crucial for meaningful clinical translation.

?

?? Anatomical Distinctions: Pigs vs. Humans. Pigs exhibit distinct pulmonary vein (PV) branching patterns, with the right cranial and middle lung lobes draining through a common ostium and the remaining lobes converging often into a second ostium. However, these common ostia are entry points—not vessels—meaning one should engage individual pulmonary veins for electrical isolation and precision. Additionally, the porcine left atrium is notably smaller than the human equivalent, especially in patients with AF and atrial dilation. Navigating the right upper PV requires careful catheter manipulation ?? due to its proximity to the fossa ovalis and a sharp S-shaped trajectory from IVC.

?

?? ICE Guidance for Transseptal Puncture. Intracardiac echocardiography (ICE) is extremely useful for guiding transseptal puncture in pigs, avoiding aortic punctures and tamponades. Success is marked by the classic 'tenting' image — ?where the fossal septum bows into the left atrium — ensuring proper positioning.

?

?? Phrenic Nerve Proximity and Ablation Safety. Careful selection of ablation energy and pulse duration is critical ?, as the left phrenic nerve crosses near the PV ostium, posing a risk of nerve injury during intra-ostial ablation.

?

?? Spontaneous AF Models: Insightful but Limited. While large animals like horses can develop spontaneous AF?? in others like sheep and goats in can be induced. However, Such models are more useful for studying AF mechanisms than guiding procedural approaches.

?

? Conclusion: Pigs remain the major model ?? for developing left atrial ablation therapies, provided their anatomical nuances—such as smaller left atria and the nature of common ostia—are understood. Meanwhile, spontaneous AF models offer valuable insights but are less practical for interventional research. Together, these models help drive breakthroughs that translate into better outcomes for patients with atrial fibrillation ??.

?

?? Join the Conversation! I am honestly curious what’s your experience with animal models in ablation research? Do you share these perspectives or have different insights?