Zang Lianru, Gu Kaihao, Zhou Tuo, Si Peng, Ji Xingkai, Zhang Hao, Yan Shengjie, Wu Xiaomei
Department of Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, 200438, China.
Cardiac Electrophysiology R&D Center, APT Medical Inc., Shenzhen, 518057, China.
J Interv Card Electrophysiol. 2024 Aug 26. doi: 10.1007/s10840-024-01872-1.
Pulsed field ablation (PFA) is an emerging non-thermal ablation method. The primary challenge is the control of multiple parameters in PFA, as the interplay of these parameters remains unclear in terms of ensuring effective and safe tissue ablation.
This study employs the response surface method (RSM) to explore the interactions between various PFA parameters and ablation outcomes, and seeks to enhance the efficacy and safety of PFA.
In vivo experiments were conducted using rabbit liver for varying PFA parameters: pulse amplitude (PA), pulse interval (PI), number of pulse trains (NT), and number of pulses in a pulse train (NP). Ablation outcomes assessed included three ablation sizes, surface temperature, and muscle contraction strength. Additionally, histological analysis was performed on the ablated tissue. We analyzed the relationship between PFA parameters and ablation outcomes, and results were then compared with those from a simulation using an electric-thermal coupling PFA finite element model.
A linear relationship between ablation outcomes and PFA parameters was established. PA and NT exhibited extremely significant (P < 0.0001) and significant effects (P < 0.05) on all ablation outcomes, respectively. NP showed an extremely significant impact (P < 0.0001) on surface temperature and muscle contraction strength, while PI significantly influenced (P < 0.05) muscle contraction strength alone. Histological analysis revealed that PFA produces controlled, well-defined areas of liver tissue necrosis. Surface temperature results from simulations and experiments were highly consistent (R > 0.97).
This study clarifies the relationship between various PFA parameters and ablation outcomes, and aims to improve the efficacy and safety of PFA.
脉冲场消融（PFA）是一种新兴的非热消融方法。主要挑战在于控制PFA中的多个参数，因为这些参数之间的相互作用在确保有效且安全的组织消融方面仍不清楚。
本研究采用响应面法（RSM）来探索各种PFA参数与消融结果之间的相互作用，并寻求提高PFA的疗效和安全性。
使用兔肝进行体内实验，设置不同的PFA参数：脉冲幅度（PA）、脉冲间隔（PI）、脉冲序列数（NT）和脉冲序列中的脉冲数（NP）。评估的消融结果包括三种消融大小、表面温度和肌肉收缩强度。此外，对消融组织进行了组织学分析。我们分析了PFA参数与消融结果之间的关系，然后将结果与使用电热耦合PFA有限元模型的模拟结果进行比较。
建立了消融结果与PFA参数之间的线性关系。PA和NT分别对所有消融结果表现出极其显著（P < 0.0001）和显著影响（P < 0.05）。NP对表面温度和肌肉收缩强度表现出极其显著的影响（P < 0.0001），而PI仅对肌肉收缩强度有显著影响（P < 0.05）。组织学分析表明，PFA产生可控的、界限清晰的肝组织坏死区域。模拟和实验的表面温度结果高度一致（R > 0.97）。
本研究阐明了各种PFA参数与消融结果之间的关系，旨在提高PFA的疗效和安全性。
