Sanchez-Somonte Paula, Verma Atul
Division of Cardiology, McGill University Health Centre, McGill University, Montreal, Québec, Canada.
Heart Int. 2022 Dec 14;16(2):85-90. doi: 10.17925/HI.2022.16.2.85. eCollection 2022.
Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation ablation. Radiofrequency ablation has been the most common source of energy used to achieve PVI until now. In recent years, cryoballoon ablation has gained popularity due to its ability to perform PVI in a 'single-shot' fashion. In both cases (radiofrequency and cryoablation), the main limitation is their inability to achieve durable lesions without causing collateral damage to adjacent structures. In contrast, pulsed electric field (PEF) ablation is a non-thermal energy source that causes cell apoptosis by applying an electric current to the tissue. Lesions created by a field of energy seem to be more contiguous than traditional ablation, and the risk of damage to adjacent tissues is largely avoided due to the properties of the tissues and electrical fields. In recent years, new catheters capable of delivering PEF have been developed and are now undergoing clinical testing. In this article, we describe a complete solution for PVI: a single multielectrode catheter with 3D mapping capabilities that can deliver PEF in a single-shot PVI fashion with targeting beyond the pulmonary veins.
肺静脉隔离（PVI）是房颤消融的基石。迄今为止，射频消融一直是实现PVI最常用的能量来源。近年来，冷冻球囊消融因其能够以“单次”方式进行PVI而受到欢迎。在这两种情况下（射频消融和冷冻消融），主要局限性在于它们无法在不损伤相邻结构的情况下实现持久的损伤。相比之下，脉冲电场（PEF）消融是一种非热能来源，通过向组织施加电流来导致细胞凋亡。由能量场产生的损伤似乎比传统消融更连续，并且由于组织和电场的特性，很大程度上避免了对相邻组织的损伤风险。近年来，能够输送PEF的新型导管已被开发出来，目前正在进行临床试验。在本文中，我们描述了一种用于PVI的完整解决方案：一种具有三维标测能力的单根多电极导管，它能够以单次PVI方式输送PEF，且靶点超出肺静脉。
