Sullivan Andrew P, Aguilar Martin, Laksman Zachary
Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.
Montreal Heart Institute, Department of Medicine, Université de Montréal, Montréal, QC H1T 1C8, Canada.
Bioengineering (Basel). 2025 Mar 22;12(4):329. doi: 10.3390/bioengineering12040329.
Pulsed field ablation (PFA) is an emerging technology that utilizes ultra-short high-voltage electric pulses to create nanopores in cell membranes, leading to cell death through irreversible electroporation (IRE). PFA is touted to be highly tissue-selective, which may mitigate the risk of collateral injury to vital adjacent structures. In the field of cardiac electrophysiology, initial studies have shown promising results for acute pulmonary vein isolation (PVI) and lesion durability, with overall freedom from recurrent atrial arrhythmia comparable to traditional thermal ablation modalities. While further large studies are required for long-term efficacy and safety data, PFA has the potential to become a preferred energy source for cardiac ablation for some indications. This review outlines the basic principles and biophysics of IRE and its application to cardiac electrophysiology through a review of the existing preclinical and clinical data.
脉冲场消融（PFA）是一种新兴技术，它利用超短高压电脉冲在细胞膜上形成纳米孔，通过不可逆电穿孔（IRE）导致细胞死亡。PFA被认为具有高度的组织选择性，这可能会降低对相邻重要结构造成附带损伤的风险。在心脏电生理学领域，初步研究已显示出急性肺静脉隔离（PVI）和损伤持久性方面的有前景的结果，总体无复发性房性心律失常的情况与传统热消融方式相当。虽然需要进一步的大型研究来获取长期疗效和安全性数据，但PFA在某些适应症方面有潜力成为心脏消融的首选能量源。本综述通过回顾现有的临床前和临床数据，概述了IRE的基本原理和生物物理学及其在心脏电生理学中的应用。
