From the Departments of Cardiology (V.J.H.M.v.D., K.G.E.J.N., H.v.W., B.C.d.P., P.A.F.M.D., F.H.M.W.) and Pathology (A.V.), University Medical Center, Utrecht, The Netherlands; and Department of Rhythmology, Alfried Krupp Hospital, Essen, Germany (K.G.E.J.N.).
Circ Arrhythm Electrophysiol. 2014 Aug;7(4):734-8. doi: 10.1161/CIRCEP.113.001111. Epub 2014 Jun 23.
Radiofrequency ablation inside pulmonary vein (PV) ostia can cause PV stenosis. A novel alternative method of ablation is irreversible electroporation, but the long-term response of PVs to electroporation ablation is unknown.
In ten 6-month-old pigs (60-75 kg), the response of PVs to circular electroporation and radiofrequency ablation was compared. Ten consecutive, nonarcing, electroporation applications of 200 J were delivered 5 to 10 mm inside 1 of the 2 main PVs, using a custom-deflectable, 18-mm circular decapolar catheter. Inside the other PV, circular radiofrequency ablation was performed using 30 W radiofrequency applications via an irrigated 4-mm ablation catheter. PV angiograms were made before ablation, immediately after ablation, and after 3-month survival. PV diameters and heart size were measured. With electroporation ablation, PV ostial diameter decreased 11±10% directly after ablation, but had increased 19±11% after 3 months. With radiofrequency ablation, PV ostial diameter decreased 23±15% directly after ablation and remained 7±17% smaller after 3 months compared with preablation diameter despite a 21±7% increase in heart size during aging from 6 to 9 months.
In this porcine model, multiple circumferential 200-J electroporation applications inside the PV ostia do not affect PV diameter at 3-month follow-up. Radiofrequency ablation inside PV ostia causes considerable PV stenosis directly after ablation, which persists after 3 months.
肺静脉（PV）口内的射频消融可能导致 PV 狭窄。一种新的消融替代方法是不可逆电穿孔，但 PV 对电穿孔消融的长期反应尚不清楚。
在 10 头 6 个月大的猪（60-75 公斤）中，比较了 PV 对环型电穿孔和射频消融的反应。使用定制的可弯曲 18 毫米圆形 18 极导管，在 2 个主 PV 中的 1 个内部，连续进行 10 次非弧形 200 J 的电穿孔应用。在另一个 PV 内，使用 30 W 射频通过灌洗 4 毫米消融导管进行圆形射频消融。在消融前、消融后即刻和 3 个月存活后进行 PV 血管造影。测量 PV 直径和心脏大小。用电穿孔消融时，PV 口直径在消融后直接减少 11±10%，但在 3 个月后增加 19±11%。在射频消融时，PV 口直径在消融后直接减少 23±15%，并且在 3 个月后与消融前直径相比仍减少 7±17%，尽管心脏大小在从 6 个月到 9 个月的老化过程中增加了 21±7%。
在这个猪模型中，PV 口内的多次 200 J 环型电穿孔应用在 3 个月随访时不会影响 PV 直径。射频消融在 PV 口内直接导致明显的 PV 狭窄，在 3 个月后仍然存在。
