Irreversible electroporation for the treatment of cardiac arrhythmias

ABSTRACT

Introduction: Cardiac ablation is an established treatment modality for the management of patients with cardiac arrhythmias. Current approaches to cardiac ablation employ thermal based energy to achieve lesions (damage) within the heart. There are many shortcomings and limitations of thermal based approaches. Electroporation (DC energy) is a non-thermal alternative approach to ablation that has shown significant promise in animal studies.

Areas covered: An extensive review of the literature on the application of electroporation for ablation (both cardiac and collateral cardiac tissue) was undertaken. This review explores irreversible electroporation as a cardiac ablation modality. Specifically, it focuses and explains the biophysics of electroporation, the limitations of current thermal based approaches and examines the current data published on electroporation cardiac ablation.

Expert commentary: Electroporation is a fast-growing novel ablation modality that has many advantages over current thermal based approaches. Current research in animal models shows its can be safely and efficaciously applied to the heart. Although further research is required, electroporation represents an appealing option for the ablation cardiac arrhythmias.

KEYWORDS:

• Electroporation
• DC energy
• cardiac ablation
• atrial fibrillation
• ventricular arrhythmias

Declaration of interest

SJ Asirvatham has intellectual property for electroporation devices that we have mentioned in this review. Receives no significant honoraria and is a consultant with Abiomed, Aegis, ATP, Atricure, Biotronik, Boston Scientific, FocusStart, Medtronic, Medtelligence, Nevro, Sanovas, Sorin Medical, Spectranetics, St. Jude, Sanofi-Aventis, Wolters Kluwer, Elsevier, Zoll. The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.