Department of Cardiology, Peking University Shougang Hospital, Beijing, China.
Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Med Sci Monit. 2024 Jul 30;30:e945007. doi: 10.12659/MSM.945007.
BACKGROUND Pulsed field ablation (PFA), as a non-thermal ablation modality, has received increasing attention. The aim of this study was to evaluate the effect of PFA upon His bundle via its implementation with different voltages on the maximum His bundle potential in canines, providing scientific basis for clinical application. MATERIAL AND METHODS Pulsed electrical field energy was delivered from a ablation catheter to the maximum His potential of 7 dogs, followed by a series of electrogram and histology assessments. RESULTS The baseline AH and HV intervals were 55.3±3.7 ms (range, 53.0-59.0 ms), and 34.9±1.3 ms (range, 34.0-36.0 ms), respectively, which were elevated to 65.0±5.4 ms (range, 59.0-70.0 ms) and 35.7±2.7 ms (range, 34.0-37.0 ms) after PFA. Before ablation and immediately after the recovery of third-degree AVB, the AH interval was prolonged (P<0.05) while the HV interval remained unchanged (P>0.05). After ablation, all 7 canines experienced transient third-degree AVB, with a voltage-dependent duration. Masson staining results revealed no apparent damage in His bundle cells. CONCLUSIONS Within a certain voltage range of pulse electric field, ablation of the maximum His potential in canines can result in transient third-degree AVB, providing a new route for guiding safe ablation of para-Hisian arrhythmia.
脉冲场消融（PFA）作为一种非热消融方式，受到了越来越多的关注。本研究旨在通过在犬只中使用不同电压对最大希氏束电位进行 PFA，评估其对希氏束的影响，为临床应用提供科学依据。
从消融导管向 7 只犬的最大希氏束电位传递脉冲电场能量，随后进行一系列电图和组织学评估。
基础 AH 和 HV 间期分别为 55.3±3.7ms（范围，53.0-59.0ms）和 34.9±1.3ms（范围，34.0-36.0ms），在 PFA 后分别升高至 65.0±5.4ms（范围，59.0-70.0ms）和 35.7±2.7ms（范围，34.0-37.0ms）。在消融前和三度房室传导阻滞恢复后即刻，AH 间期延长（P<0.05），而 HV 间期保持不变（P>0.05）。消融后，7 只犬均发生一过性三度房室传导阻滞，具有电压依赖性持续时间。Masson 染色结果显示希氏束细胞无明显损伤。
在脉冲电场的一定电压范围内，消融犬只的最大希氏束电位可导致一过性三度房室传导阻滞，为指导安全消融希氏旁性心律失常提供了新途径。
