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@article{1405760,
author = {Wojtaszczyk, Adam and Caluori, Guido and Pešl, Martin and Melajová, Katarína and Stárek, Zdeněk},
article_location = {HOBOKEN},
article_number = {4},
doi = {http://dx.doi.org/10.1111/jce.13454},
keywords = {atrial fibrillation; fibrosis; irreversible electroporation; nonthermal ablation; pulmonary vein isolation},
language = {eng},
issn = {1045-3873},
journal = {JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY},
title = {Irreversible electroporation ablation for atrial fibrillation},
url = {https://onlinelibrary.wiley.com/doi/full/10.1111/jce.13454},
volume = {29},
year = {2018}
}
TY - JOUR
ID - 1405760
AU - Wojtaszczyk, Adam - Caluori, Guido - Pešl, Martin - Melajová, Katarína - Stárek, Zdeněk
PY - 2018
TI - Irreversible electroporation ablation for atrial fibrillation
JF - JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
VL - 29
IS - 4
SP - 643-651
EP - 643-651
PB - WILEY
SN - 10453873
KW - atrial fibrillation
KW - fibrosis
KW - irreversible electroporation
KW - nonthermal ablation
KW - pulmonary vein isolation
UR - https://onlinelibrary.wiley.com/doi/full/10.1111/jce.13454
L2 - https://onlinelibrary.wiley.com/doi/full/10.1111/jce.13454
N2 - Atrial fibrillation (AF) is one of the most important problems in modern cardiology. Thermal ablation therapies, especially radiofrequency ablation (RF), are currently "gold standard" to treat symptomatic AF by localized tissue necrosis. Despite the improvements in reestablishing sinus rhythm using available methods, both success rate and safety are limited by the thermal nature of procedures. Thus, while keeping the technique in clinical practice, safer and more versatile methods of removing abnormal tissue are being investigated. This review focuses on irreversible electroporation (IRE), a nonthermal ablation method, which is based on the unrecoverable permeabilization of cell membranes caused by short pulses of high voltage/current. While still in its preclinical steps for what concerns interventional cardiac electrophysiology, multiple studies have shown the efficacy of this method on animal models. The observed remodeling process shows this technique as tissue specific, triggering apoptosis rather than necrosis, and safer for the structures adjacent the myocardium. So far, proposed IRE methodologies are heterogeneous. The number of devices (both generators and applicators), techniques, and therapeutic goals impair the comparability of performed studies. More questions regarding systemic safety and optimal processes for AF treatment remain to be answered. This work provides an overview of the electroporation process, and presents different results obtained by cardiology-oriented research groups that employ IRE ablation, with focus of AF-related targets. This contribution on the topic aspires to be a practical guide to approach IRE ablation for cardiac arrhythmias, and to highlight controversial features and existing knowledge, to provide background for future improved experimentation with IRE in arrhythmology.
ER -
WOJTASZCZYK, Adam, Guido CALUORI, Martin PEŠL, Katarína MELAJOVÁ and Zdeněk STÁREK. Irreversible electroporation ablation for atrial fibrillation. \textit{JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY}. HOBOKEN: WILEY, 2018, vol.~29, No~4, p.~643-651. ISSN~1045-3873. Available from: https://dx.doi.org/10.1111/jce.13454.
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