Tabaja Chadi, Mdaihly Mohamad, Noujaim Charbel, Wazni Oussama M, Santangeli Pasquale
Cardiac Electrophysiology and Pacing Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
Cardiac Electrophysiology and Pacing Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
Card Electrophysiol Clin. 2025 Jun;17(2):147-154. doi: 10.1016/j.ccep.2025.02.003. Epub 2025 Mar 26.
Over the last 2 decades, thermal-based catheter ablation has remained the mainstay treatment of cardiac arrhythmias. Although rare, thermal ablation can extend beyond the myocardium resulting in serious adverse events namely pulmonary vein stenosis, esophagus and phrenic nerve injury. In contrast, pulsed field ablation (PFA) has emerged as a promising technique that creates nonthermal lesions in cardiac tissue through the mechanism of irreversible electroporation (IRE). IRE involves the application of short-duration high-voltage pulsed electrical fields leading to cell death through membrane destabilization in a tissue-specific manner. This article discusses the mechanisms of electroporation while highlighting the tissue selectivity of PFA.
在过去20年里，基于热效应的导管消融一直是心律失常的主要治疗方法。尽管热消融导致严重不良事件（即肺静脉狭窄、食管和膈神经损伤）的情况罕见，但这种情况会超出心肌范围。相比之下，脉冲场消融（PFA）作为一种有前景的技术应运而生，它通过不可逆电穿孔（IRE）机制在心脏组织中产生非热损伤。IRE包括施加短持续时间的高压脉冲电场，以组织特异性方式通过细胞膜去稳定化导致细胞死亡。本文讨论了电穿孔机制，同时强调了PFA的组织选择性。
