心脏脉冲电场消融治疗心房颤动的研究进展

曹子钧; 尹宗涛

doi:10.13201/j.issn.1001-1439.2023.08.006

心脏脉冲电场消融治疗心房颤动的研究进展

曹子钧^1,2,
尹宗涛^2, ,

- 1.
  辽宁中医药大学研究生学院(沈阳，116600)
- 2.
  北部战区总医院心血管外科
基金项目:
辽宁省民生科技计划联合计划项目(No: 2021JH2/10300082)

详细信息

通讯作者: 尹宗涛, E-mail: yzt711210@sina.com

中图分类号: R541.7

收稿日期: 2022-09-13

刊出日期: 2023-08-13

Research progress of pulsed field ablation in cardiac surgery for atrial fibrillation

CAO Zijun^1,2,
YIN Zongtao^2, ,

- 1.
  Graduate School of Liaoning University of Traditional Chinese Medicine, Shenyang, 116600, China
- 2.
  Department of Cardiovascular Surgery, Northern Theater General Hospital

More Information

Corresponding author: YIN Zongtao, E-mail: yzt711210@sina.com

Received Date: 13 September 2022

Publish Date: 13 August 2023

摘要

摘要: 具有非热特性和独特的组织特异性的脉冲电场消融技术为外科消融治疗心房颤动提供了新的选择，与传统的外科消融方式相比，脉冲电场消融具有更高的安全性及有效性。本文主要介绍脉冲电场消融的原理、治疗心房颤动等方面的研究进展。
- 心房颤动 /
- 脉冲电场 /
- 不可逆电穿孔 /
- 心脏消融
Abstract: Pulsed field ablation with non-thermal characteristics and unique tissue specificity provides a new choice for surgical ablation of atrial fibrillation. Compared with traditional surgical ablation, pulsed field ablation is more safe and effective. This paper mainly introduces the principle of pulsed field ablation and the clinical research progress in the treatment of atrial fibrillation.
- atrial fibrillation /
- pulsed field ablation /
- irreversible electroporation /
- cardiac ablation

HTML全文

参考文献(36)

[1]	Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: A Global Burden of Disease 2010 Study[J]. Circulation, 2014, 129(8): 837-847. doi: 10.1161/CIRCULATIONAHA.113.005119
[2]	Mark DB, Anstrom KJ, Sheng S, et al. Effect of catheter ablation vs medical therapy on quality of life among patients with atrial fibrillation: the CABANA Randomized Clinical Trial[J]. JAMA, 2019, 321(13): 1275-1285. doi: 10.1001/jama.2019.0692
[3]	Kuck KH, Brugada J, Fürnkranz A, et al. FIRE AND ICE investigators. cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation[J]. N Engl J Med, 2016, 374(23): 2235-2245. doi: 10.1056/NEJMoa1602014
[4]	Reddy VY, Dukkipati SR, Neuzil P, et al. Pulsed field ablation of paroxysmal atrial fibrillation: 1-year outcomes of IMPULSE, PEFCAT, and PEFCAT Ⅱ[J]. JACC Clin Electrophysiol, 2021, 7(5): 614-627. doi: 10.1016/j.jacep.2021.02.014
[5]	Lavee J, Onik G, Mikus P, et al. A novel nonthermal energy source for surgical epicardial atrial ablation: irreversible electroporation[J]. Heart Surg Forum, 2007, 10(2): E162-167. doi: 10.1532/HSF98.20061202
[6]	Neven K, van Driel V, van Wessel H, et al. Epicardial linear electroporation ablation and lesion size[J]. Heart Rhythm, 2014, 11(8): 1465-1470. doi: 10.1016/j.hrthm.2014.04.031
[7]	Reddy VY, Koruth J, Jais P, et al. Ablation of atrial fibrillation with pulsed electric fields: an ultra-rapid, tissue-selective modality for cardiac ablation[J]. JACC Clin Electrophysiol, 2018, 4(8): 987-995. doi: 10.1016/j.jacep.2018.04.005
[8]	Bradley CJ, Haines DE. Pulsed field ablation for pulmonary vein isolation in the treatment of atrial fibrillation[J]. J Cardiovasc Electrophysiol, 2020, 31(8): 2136-2147. doi: 10.1111/jce.14414
[9]	张家明, 陈志坚. 心房颤动消融的新视角———脉冲电场消融[J]. 临床心血管病杂志, 2022, 38(11): 851-854. https://lcxxg.whuhzzs.com/article/doi/10.13201/j.issn.1001-1439.2022.11.002
[10]	Yarmush ML, Golberg A, Serša G, et al. Electroporation-based technologies for medicine: principles, applications, and challenges[J]. Annu Rev Biomed Eng, 2014, 16: 295-320. doi: 10.1146/annurev-bioeng-071813-104622
[11]	Di Biase L, Diaz JC, Zhang XD, et al. Pulsed field catheter ablation in atrial fibrillation[J]. Trends Cardiovasc Med, 2022, 32(6): 378-387. doi: 10.1016/j.tcm.2021.07.006
[12]	Rubinsky B. Irreversible electroporation in medicine[J]. Technol Cancer Res Treat, 2007, 6(4): 255-260. doi: 10.1177/153303460700600401
[13]	Howard B, Haines DE, Verma A, et al. Reduction in pulmonary vein stenosis and collateral damage with pulsed field ablation compared with radiofrequency ablation in a canine model[J]. Circ Arrhythm Electrophysiol, 2020, 13(9): e008337. doi: 10.1161/CIRCEP.120.008337
[14]	Stewart MT, Haines DE, Verma A, et al. Intracardiac pulsed field ablation: Proof of feasibility in a chronic porcine model[J]. Heart Rhythm, 2019, 16(5): 754-764. doi: 10.1016/j.hrthm.2018.10.030
[15]	Kaminska I, Kotulska M, Stecka A, et al. Electroporation-induced changes in normal immature rat myoblasts(H9C2)[J]. Gen Physiol Biophys, 2012, 31(1): 19-25. doi: 10.4149/gpb_2012_003
[16]	Reddy VY, Neuzil P, Koruth JS, et al. Pulsed field ablation for pulmonary vein isolation in atrial fibrillation[J]. J Am Coll Cardiol, 2019, 74(3): 315-326. doi: 10.1016/j.jacc.2019.04.021
[17]	Das M, Wynn GJ, Saeed Y, et al. Pulmonary vein re-isolation as a routine strategy regardless of symptoms: the PRESSURE Randomized Controlled Trial[J]. JACC Clin Electrophysiol, 2017, 3(6): 602-611. doi: 10.1016/j.jacep.2017.01.016
[18]	Iwasawa J, Koruth JS, Petru J, et al. Temperature-controlled radiofrequency ablation for pulmonary vein isolation in patients with atrial fibrillation[J]. J Am Coll Cardiol, 2017, 70(5): 542-553. doi: 10.1016/j.jacc.2017.06.008
[19]	Hussein A, Das M, Riva S, et al. Use of ablation index-guided ablation results in high rates of durable pulmonary vein isolation and freedom from arrhythmia in persistent atrial fibrillation patients: The PRAISE study results[J]. Circ Arrhythm Electrophysiol, 2018, 11(9): e006576. doi: 10.1161/CIRCEP.118.006576
[20]	Kawamura I, Neuzil P, Shivamurthy P, et al. Does pulsed field ablation regress over time? A quantitative temporal analysis of pulmonary vein isolation[J]. Heart Rhythm, 2021, 18(6): 878-884. doi: 10.1016/j.hrthm.2021.02.020
[21]	Bai R, Di Biase L, Mohanty P, et al. Proven isolation of the pulmonary vein antrum with or without left atrial posterior wall isolation in patients with persistent atrial fibrillation[J]. Heart Rhythm, 2016, 13(1): 132-140. doi: 10.1016/j.hrthm.2015.08.019
[22]	Muneretto C, Bisleri G, Rosati F, et al. European prospective multicentre study of hybrid thoracoscopic and transcatheter ablation of persistent atrial fibrillation: the HISTORIC-AF trial[J]. Eur J Cardiothorac Surg, 2017, 52(4): 740-745. doi: 10.1093/ejcts/ezx162
[23]	Reddy VY, Anic A, Koruth J, et al. Pulsed field ablation in patients with persistent atrial fibrillation[J]. J Am Coll Cardiol, 2020, 76(9): 1068-1080. doi: 10.1016/j.jacc.2020.07.007
[24]	Yavin H, Shapira-Daniels A, Barkagan M, et al. Pulsed field ablation using a lattice electrode for focal energy delivery: biophysical characterization, lesion durability, and safety evaluation[J]. Circ Arrhythm Electrophysiol, 2020, 13(6): e008580. doi: 10.1161/CIRCEP.120.008580
[25]	Neven K, van Driel V, van Wessel H, et al. Myocardial lesion size after epicardial electroporation catheter ablation after subxiphoid puncture[J]. Circ Arrhythm Electrophysiol, 2014, 7(4): 728-733. doi: 10.1161/CIRCEP.114.001659
[26]	Christopoulos G, Ladejobi A, Tri J, et al. Effects of pulsed electicfields on the coronary vasculature in swine[J]. Heart Rhythm, 2021, 18(8): S329.
[27]	Neven K, van EsR, van Driel V, et al. Acute and long-term effects of full-power electroporation ablation directly on the porcine esophagus[J]. Circ Arrhythm Electrophysiol, 2017, 10(5): e004672. doi: 10.1161/CIRCEP.116.004672
[28]	Koruth JS, Kuroki K, Kawamura I, et al. Pulsed field ablation versus radiofrequency ablation: esophageal injury in a novel porcine model[J]. Circ Arrhythm Electrophysiol, 2020, 13(3): e008303. doi: 10.1161/CIRCEP.119.008303
[29]	Lv Y, Zhang Y, Huang J, et al. A study on nonthermal irreversible electroporation of the thyroid[J]. Technol Cancer Res Treat, 2019, 18: 1533033819876307.
[30]	Sano MB, Fan RE, Cheng K, et al. Reduction of muscle contractions during irreversible electroporation therapy using high-frequency bursts of alternating polarity pulses: a laboratory investigation in an ex vivo swine model[J]. J Vasc Interv Radiol, 2018, 29(6): 893-898. e4. doi: 10.1016/j.jvir.2017.12.019
[31]	Cochet H, Nakatani Y, Sridi-Cheniti S, et al. Pulsed field ablation selectively spares the oesophagus during pulmonary vein isolation for atrial fibrillation[J]. Europace, 2021, 23(9): 1391-1399. doi: 10.1093/europace/euab090
[32]	van Es R, Konings MK, Du Pré BC, et al. High-frequency irreversible electroporation for cardiac ablation using an asymmetrical waveform[J]. Biomed Eng Online, 2019, 18(1): 75. doi: 10.1186/s12938-019-0693-7
[33]	Kuroki K, Whang W, Eggert C, et al. Ostial dimensional changes after pulmonary vein isolation: Pulsed field ablation vs radiofrequency ablation[J]. Heart Rhythm, 2020, 17(9): 1528-1535. doi: 10.1016/j.hrthm.2020.04.040
[34]	Grimaldi M, Di Monaco A, Gomez T, et al. Time course of irreversible electroporation lesion development through short-and long-term follow-up in pulsed-field ablation-treated hearts[J]. Circ Arrhythm Electrophysiol, 2022, 15(7): e010661.
[35]	Reddy VY, Petru J, Funasako M, et al. Coronary arterial spasm during pulsed field ablation to treat atrial fibrillation[J]. Circulation, 2022, 40: 111.
[36]	Howard B, Verma A, Tzou WS, et al. Effects of electrode-tissue proximity on cardiac lesion formation using pulsed field ablation[J]. Circ Arrhythm Electrophysiol, 2022, 15(10): e011110.