ABSTRACT
In recent years, the prevalence of and mortality associated with cardiovascular diseases have been rising in most countries and regions. AF is the most common arrhythmic condition, and there are several treatment options for AF. Pulmonary vein isolation is an effective treatment for AF and is the cornerstone of current ablation techniques, which have one major limitation: even when diagnosed and treated at a facility that specializes in ablation, patients have a greater chance of recurrence. Therefore, there is a need to develop better ablation techniques for the treatment of AF. This article first compares the current cryoablation (CBA) and radiofrequency ablation (RFA) techniques for the treatment of AF and discusses the utility and advantages of the development of pulsed-field ablation (PFA) technology. The current research on PFA is summarized from three perspectives, namely, simulation experiments, animal experiments, and clinical studies. The results of different stages of experiments are summarized, especially during animal studies, where pulmonary vein isolation was carried out effectively without causing injury to the phrenic nerve, esophagus, and pulmonary veins, with higher safety and shorter incision times. This paper focuses on a review of various a priori and clinical studies of this new technique for the treatment of AF.
ABSTRACT
BACKGROUND: At present, the effects of discharge modes of multielectrode catheters on the distribution of pulsed electric fields have not been completely clarified. Therefore, the control of the distribution of the pulsed electric field by selecting the discharge mode remains one of the key technical problems to be solved. METHODS: We constructed a model including myocardium, blood, and a flower catheter. Subsequently, by setting different positive and ground electrodes, we simulated the electric field distribution in the myocardium of four discharge modes (A, B, C, and D) before and after the catheter rotation and analyzed their mechanisms. RESULTS: Modes B, C, and D formed a continuous circumferential ablation lesion without the rotation of the catheter, with depths of 1.6 mm, 2.7 mm, and 0.7 mm, respectively. After the catheter rotation, the four modes could form a continuous circumferential ablation lesion with widths of 10.8 mm, 10.6 mm, 11.8 mm, and 11.5 mm, respectively, and depths of 5.2 mm, 2.7 mm, 4.7 mm, and 4.0 mm, respectively. CONCLUSIONS: The discharge mode directly affects the electric field distribution in the myocardium. Our results can help improve PFA procedures and provide enlightenment for the design of the discharge mode with multielectrode catheters.
ABSTRACT
Pulsed electric field(PEF) provides high-energy instantaneous pulse and release energy to myocardial cell membrane, resulting in irreversible electroporation and causes myocardial cell contents leakage, destruction of intracellular homeostasis, cell death, and slight inflammatory response. PEF as non-thermal energy promotes the design and application of arrhythmia ablation catheter to enter a new stage. There are currently limited clinical studies that have proved the safety and effectieness of Farawave PEF catheter, PVAC GOLD PEF catheter, Lattice-tip Sphere-9 PEF and radiofrequency (RF) catheter used for atrial fibrillation ablation, but still need further discussion. The research of atrial fibrillation ablation with PEF is under study in China. In this paper, the design and application of PEF ablation for tachyarrhythmia are reviewed.
Subject(s)
Atrial Fibrillation , Catheter Ablation , Pulmonary Veins , Atrial Fibrillation/surgery , Catheters , Humans , Pulmonary Veins/surgery , TachycardiaABSTRACT
Pulsed electric field(PEF) provides high-energy instantaneous pulse and release energy to myocardial cell membrane, resulting in irreversible electroporation and causes myocardial cell contents leakage, destruction of intracellular homeostasis, cell death, and slight inflammatory response. PEF as non-thermal energy promotes the design and application of arrhythmia ablation catheter to enter a new stage. There are currently limited clinical studies that have proved the safety and effectieness of Farawave PEF catheter, PVAC GOLD PEF catheter, Lattice-tip Sphere-9 PEF and radiofrequency (RF) catheter used for atrial fibrillation ablation, but still need further discussion. The research of atrial fibrillation ablation with PEF is under study in China. In this paper, the design and application of PEF ablation for tachyarrhythmia are reviewed.
Subject(s)
Humans , Atrial Fibrillation/surgery , Catheter Ablation , Catheters , Pulmonary Veins/surgery , TachycardiaABSTRACT
Atrial fibrillation, also known as atrial fibrillation, is a common cardiac arrhythmia, and its incidence increases with age. Catheter ablation is considered to be an effective means to treat atrial fibrillation and maintain sinus rhythm. The common ablation technologies are radiofrequency ablation and cryoablation. However, the existing catheter ablation technology has a "zero-sum effect", and it is difficult to control the optimal dose clinically. In this study, a new method of pulsed electric field ablation for atrial fibrillation was proposed, which effectively solved the "zero-sum effect" problem of temperature ablation. The clinical application results show that the proposed technology effectively overcomes the shortcomings of existing temperature ablation, and can form durable pulmonary vein isolation.
