Department of Cardiology, Isala Hospital, Heart Centre, Dr Van Heesweg 2, 8025 AB Zwolle, The Netherlands.
Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands.
Europace. 2021 Mar 8;23(3):464-468. doi: 10.1093/europace/euaa280.
We investigated the efficacy of linear multi-electrode irreversible electroporation (IRE) ablation in a porcine model.
The study was performed in six pigs (weight 60-75 kg). After median sternotomy and opening of the pericardium, a pericardial cradle was formed and filled with blood. A linear seven polar 7-Fr electrode catheter with 2.5 mm electrodes and 2.5 mm inter-electrode spacing was placed in good contact with epicardial tissue. A single IRE application was delivered using 50 J at one site and 100 J at two other sites, in random sequence, using a standard monophasic defibrillator connected to all seven electrodes connected in parallel. The pericardium and thorax were closed and after 3 weeks survival animals were euthanized. A total of 82 histological sections from all 18 electroporation lesions were analysed. A total of seven 50 J and fourteen 100 J epicardial IRE applications were performed. Mean peak voltages at 50 and 100 J were 1079.2 V ± 81.1 and 1609.5 V ± 56.8, with a mean peak current of 15.4 A ± 2.3 and 20.2 A ± 1.7, respectively. Median depth of the 50 and 100 J lesions were 3.2 mm [interquartile range (IQR) 3.1-3.6] and 5.5 mm (IQR 4.6-6.6) (P < 0.001), respectively. Median lesion width of the 50 and 100 J lesions was 3.9 mm (IQR 3.7-4.8) and 5.4 mm (IQR 5.0-6.3), respectively (P < 0.001). Longitudinal sections showed continuous lesions for 100 J applications.
Epicardial multi-electrode linear application of IRE pulses is effective in creating continuous deep lesions.
我们研究了线性多电极不可逆电穿孔（IRE）消融在猪模型中的疗效。
该研究在 6 头猪（体重 60-75kg）中进行。胸骨正中切开和心包打开后，形成心包托并充满血液。将一个带有 2.5mm 电极和 2.5mm 电极间距离的线性 7 极 7Fr 电极导管与心外膜组织良好接触。使用标准单相除颤器将所有 7 个电极并联连接，在一个部位以 50J 进行单次 IRE 应用，在另外两个部位以 100J 进行随机顺序的应用。心包和胸腔关闭，3 周后存活动物被安乐死。对所有 18 个电穿孔病变的 82 个组织学切片进行了分析。共进行了 7 次 50J 和 14 次 100J 心外膜 IRE 应用。50J 和 100J 时的平均峰值电压分别为 1079.2V±81.1 和 1609.5V±56.8，平均峰值电流分别为 15.4A±2.3 和 20.2A±1.7。50J 和 100J 病变的中位深度分别为 3.2mm（IQR 3.1-3.6）和 5.5mm（IQR 4.6-6.6）（P<0.001）。50J 和 100J 病变的中位宽度分别为 3.9mm（IQR 3.7-4.8）和 5.4mm（IQR 5.0-6.3）（P<0.001）。纵切面显示 100J 应用可产生连续的病变。
心外膜多电极线性应用 IRE 脉冲可有效产生连续的深部病变。
