Lindemann F, Nedios S, Seewöster T, Hindricks G
Abteilung für Elektrophysiologie, Herzzentrum Leipzig, Strümpellstr. 39, 04289, Leipzig, Deutschland.
Herz. 2021 Aug;46(4):318-322. doi: 10.1007/s00059-021-05047-w. Epub 2021 Jun 17.
Atrial fibrillation is the most common supraventricular arrhythmia with increasing incidence and prevalence. Until now, thermal energy sources such as radiofrequency or cryoablation have been used for pulmonary vein isolation of atrial fibrillation but these have led to indiscriminate tissue destruction in the target area. Pulsed field ablation (PFA) is an energy modality that does not utilize thermal effects. An ultrarapid electric field produces irreversible changes in cell membrane pores (irreversible electroporation) culminating in cell death. The myocardium is very sensitive to PFA compared to the esophagus, the pulmonary veins or the phrenic nerve. Consequently, it is possible to perform effective ablation of the pulmonary veins in a very short time and to make the treatment time more effective without causing relevant collateral damage. The treatment offers a potential paradigm shift from catheter ablation of cardiac arrhythmia.
心房颤动是最常见的室上性心律失常，其发病率和患病率不断上升。到目前为止，热能来源如射频或冷冻消融已被用于心房颤动的肺静脉隔离，但这些方法会导致目标区域的组织被随意破坏。脉冲场消融（PFA）是一种不利用热效应的能量方式。超快速电场会使细胞膜孔产生不可逆变化（不可逆电穿孔），最终导致细胞死亡。与食管、肺静脉或膈神经相比，心肌对PFA非常敏感。因此，有可能在极短的时间内对肺静脉进行有效消融，并使治疗时间更有效，而不会造成相关的附带损伤。这种治疗方法可能会给心律失常的导管消融带来潜在的范式转变。
