Cardiac ablation effectiveness through intracardiac electrogram analysis and numerical modellingŠtublar, Jernej (Avtor) Miklavčič, Damijan (Mentor) Žižek, David (Komentor) intra-cardiac electrocardiogramatrial fibrillationradiofrequency ablationcardiac ablation by electroporationcurrent-induced damage to cardiac muscle tissuedoctoral degreesCatheter ablation is a cornerstone treatment for atrial fibrillation, aiming to eliminate arrhythmogenic tissue by creating lesions in a pulmonary vein isolation procedure. Despite widespread clinical use, assessing lesion completeness remains challenging, often leading to ineffective ablation or unnecessary collateral adjacent tissue damage. This research focuses on the evaluation of lesion creation using intracardiac electrograms (iEGMs) analysis and numerical modelling to improve real-time lesion assessment, with an emphasis on lesions created by pulsed field ablation (PFA). This thesis combines preclinical and early clinical data with computational modelling (two-dimensional, monodomain) to simulate iEGM generation after PFA. Bipolar and unipolar iEGMs were recorded before and after ablation using standard electrophysiological recording equipment. Changes in iEGM amplitude and morphology were analysed using discrete wavelet transform (DWT) to separate the depolarization from the current of injury (COI) components of iEGMs. A clear distinction between transmural and nontransmural lesions in unipolar iEGM dynamics after PFA was found, particularly in the low-frequency band (1–16 Hz) - COI, which showed also a strong correlation with gross pathology confirmed lesion size. Numerical modelling supported the empirical findings by replicating key observations made during and after PFA in preclinical and clinical settings. These simulations further provided mechanistic insights into observed iEGMs changes due to chronic lesion formation and transient (reversible) effects, that occur after PFA. This work demonstrates that COI, derived from unipolar iEGMs, may have a predictive value for determining lesion transmurality and lesion volume after PFA. The results lay the foundation for developing real-time feedback tools to guide ablation procedures and optimize PFA delivery. Additionally, the integration of proposed signal processing and numerical modelling provides a comprehensive framework to support innovation in cardiac ablation technology. This thesis contributes to bridging the gap between changes in iEGMs and clinical decision-making in electrophysiology procedures using PFA.J. Štublar20262026-05-20 12:05:01Doktorsko delo/naloga182662UDK: 602.621:616.12-008.318(043.3)VisID: 52241COBISS_ID: 284611843sl