Real-Time Prediction of Irreversible Lesion Size During Pulsed Field Ablation: Prospective Validation of a Novel Ablation Index Based on Contact Force and Number of Applications in a Swine Beating Heart Model

A novel PF-ablation index incorporating CF and the number of PFA pulses provides high accuracy in predicting lesion depth in real-time. Intracardiac electrogram attenuation, impedance decrease, and electrode temperature are poor predictors of PFA lesion size.