Ablations have become the gold clinical standard of drug resistant atrial fibrillation (AF). AF is projected to affect 50 million people by the year 20501. Today, two primary methods of ablation are used clinically: radio frequency and cryoablation. These ablation technologies are equally effective1 but still cause complications. A majority of these complications arise from the fact that both technologies require a thermal change in the tissue to cause cell death.
Thermal change of the tissue while effective, can be subject to many different variables that may result in collateral damage. These include levels of focal blood flow, location of vessels near the ablation site, and/or adjacent tissue damage causing clinical issues such as esophageal fistulas or phrenic nerve injury. Irreversible Electroporation serves as a possible non-thermal alternative. This therapy is a train of high voltage (>500V/cm) short DC pulses that cause pores to form in the cell membrane. If a large enough electric field is applied, then the pores in the cell membrane can cause permanent damage resulting in cell death.
To date, the majority of irreversible electroporation research that has been done has examined the use of this approach for treating cancerous tumors in the skin, prostate, and liver. Very little study of this potential treatment relating to the heart has been done other than synchronizing delivery of the therapy with the heartbeat to not induce ventricular fibrillation. The appeal of a potentially more predictable lesion would be highly desired in this clinical realm. Here we present initial investigations as to the functional response of cardiac tissue to electroporative energy via the NanoKnife.