Ablation check pulse routine and integration for electroporation

A medical system, comprising:

• a medical device having a treatment element with a plurality of electrodes;
• a stimulation monitoring device, the stimulation monitoring device including:
• an electromyography device being configured to record diaphragmatic and thoracic measurements;
• and
• an accelerometer being configured to detect diaphragmatic movement;
• a sensor associated with the medical device;
• and
• a control unit in communication with the treatment element, the stimulation monitoring device and the sensor, the sensor being configured to monitor operating parameters of the medical system and output a signal to the control unit, the control unit including an ablation energy source and being configured to:
• determine an ablation energy routine;
• determine a low-voltage, pre-treatment pulse routine based on the ablation energy routine, the low-voltage, pre-treatment pulse routine including a delivery of energy having a voltage between 0.1 V and 40 V;
• deliver the low-voltage, pre-treatment pulse routine through the plurality of electrodes to an area of target tissue;
• determine, based on a magnitude of a stimulation response to the low-voltage, pre-treatment pulse routine in an area of non-target tissue and further based on data specifying a relationship between observed stimulation, voltage, pulse width, and distance between the treatment element and the area of non-target tissue, at least one energy delivery parameter for delivering ablative energy through the treatment element that can safely be delivered to the area of target tissue without adversely affecting the area of non-target tissue;
• and
• deliver ablation energy through the plurality of electrodes to the area of target tissue using the at least one energy delivery parameter.