Gunawardene Melanie, Arentz Thomas
Kardiologie und Internistische Intensivmedizin, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland.
Sektion Rhythmologie, Klinik für Kardiologie und Angiologie II, Universitätsklinikum Freiburg, Freiburg, Deutschland.
Herzschrittmacherther Elektrophysiol. 2024 Dec;35(4):263-267. doi: 10.1007/s00399-024-01035-9. Epub 2024 Sep 3.
Pulsed field ablation (PFA) is a nonthermal energy source used for cardiac ablation procedures. Cell death during PFA occurs via electroporation: ultrarapid (micro- to nanosecond) electrical pulses are applied to destabilize cell membranes causing irreversible pores. PFA leads to preferential ablation of myocardiocytes, sparing adjacent tissue like the esophagus or phrenic nerve. Preliminary clinical studies show high efficacy and a good safety profile in atrial fibrillation patients undergoing pulmonary vein isolation. The question remains, however, whether this new technology will replace well-known and established thermal energy sources like radiofrequency current or cryoablation within the next 5 years.
脉冲场消融（PFA）是一种用于心脏消融手术的非热能来源。PFA过程中的细胞死亡通过电穿孔发生：施加超快速（微秒至纳秒）电脉冲以使细胞膜不稳定，从而形成不可逆的孔。PFA导致心肌细胞优先消融，使食管或膈神经等相邻组织得以保留。初步临床研究表明，在接受肺静脉隔离的房颤患者中，PFA具有高疗效和良好的安全性。然而，问题仍然存在，即这项新技术在未来5年内是否会取代如射频电流或冷冻消融等知名且成熟的热能来源。
