Nakagawa Hiroshi, Ikeda Atsushi, Yokoyama Katsuaki, An Yoshimori, Hussein Ayman A, Saliba Walid I, Wazni Oussama M, Castellvi Quim
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Card Electrophysiol Clin. 2022 Dec;14(4):757-767. doi: 10.1016/j.ccep.2022.08.003.
Current ablation systems rely on thermal energy to produce ablation lesions (heating: RF, laser and ultrasound, and cooling: cryo-thermia). While thermal ablation has been proven to be effective, there are several limitations: 1) relatively long procedural times; 2) high recurrence rate of ventricular arrhythmias; and 3) excessive heating potentially leading to serious complications, including steam pop (perforation), coronary arterial injury and thrombo-embolism. Pulsed field ablation (PFA)/irreversible electroporation (IRE) offers a unique non-thermal ablation strategy which has the potential to overcome these limitations. Recent pre-clinical studies suggest that PFA/IRE might be effective and safe for the treatment of cardiac arrhythmias.
目前的消融系统依靠热能来产生消融灶（加热：射频、激光和超声，以及冷却：低温冷冻）。虽然热消融已被证明是有效的，但仍存在一些局限性：1）手术时间相对较长；2）室性心律失常复发率高；3）过度加热可能导致严重并发症，包括蒸汽泡（穿孔）、冠状动脉损伤和血栓栓塞。脉冲场消融（PFA）/不可逆电穿孔（IRE）提供了一种独特的非热消融策略，有可能克服这些局限性。最近的临床前研究表明，PFA/IRE可能对治疗心律失常有效且安全。
