TY - JOUR
T1 - Irreversible electroporation for catheter-based cardiac ablation
T2 - a systematic review of the preclinical experience
AU - Sugrue, Alan
AU - Vaidya, Vaibhav
AU - Witt, Chance
AU - DeSimone, Christopher V.
AU - Yasin, Omar
AU - Maor, Elad
AU - Killu, Ammar M.
AU - Kapa, Suraj
AU - McLeod, Christopher J.
AU - Miklavčič, Damijan
AU - Asirvatham, Samuel J.
N1 - Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2019/9/15
Y1 - 2019/9/15
N2 - Introduction: Irreversible electroporation (IRE) utilizing high voltage pulses is an emerging strategy for catheter-based cardiac ablation with considerable growth in the preclinical arena. Methods: A systematic search for articles was performed from three sources (PubMed, EMBASE, and Google Scholar). The primary outcome was the efficacy of tissue ablation with characteristics of lesion formation evaluated by histologic analysis. The secondary outcome was focused on safety and damage to collateral structures. Results: Sixteen studies met inclusion criteria. IRE was most commonly applied to the ventricular myocardium (n = 7/16, 44%) by a LifePak 9 Defibrillator (n = 9/16, 56%), NanoKnife Generator (n = 2/16, 13%), or other custom generators (n = 5/16, 31%). There was significant heterogeneity regarding electroporation protocols. On histological analysis, IRE was successful in creating ablation lesions with variable transmurality depending on the electric pulse parameters and catheter used. Conclusion: Preclinical studies suggest that cardiac tissue ablation using IRE shows promise in delivering efficacious, safe lesions.
AB - Introduction: Irreversible electroporation (IRE) utilizing high voltage pulses is an emerging strategy for catheter-based cardiac ablation with considerable growth in the preclinical arena. Methods: A systematic search for articles was performed from three sources (PubMed, EMBASE, and Google Scholar). The primary outcome was the efficacy of tissue ablation with characteristics of lesion formation evaluated by histologic analysis. The secondary outcome was focused on safety and damage to collateral structures. Results: Sixteen studies met inclusion criteria. IRE was most commonly applied to the ventricular myocardium (n = 7/16, 44%) by a LifePak 9 Defibrillator (n = 9/16, 56%), NanoKnife Generator (n = 2/16, 13%), or other custom generators (n = 5/16, 31%). There was significant heterogeneity regarding electroporation protocols. On histological analysis, IRE was successful in creating ablation lesions with variable transmurality depending on the electric pulse parameters and catheter used. Conclusion: Preclinical studies suggest that cardiac tissue ablation using IRE shows promise in delivering efficacious, safe lesions.
KW - Arrhythmias
KW - Atrial fibrillation
KW - Cardiac ablation
KW - Catheter ablation
KW - Irreversible electroporation
KW - Pulsed electric field
KW - Translational studies
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U2 - 10.1007/s10840-019-00574-3
DO - 10.1007/s10840-019-00574-3
M3 - Article
C2 - 31270656
AN - SCOPUS:85068862911
SN - 1383-875X
VL - 55
SP - 251
EP - 265
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
IS - 3
ER -