PDF(Pubmed)
Abstract：
The use of catheter-based irreversible electroporation in clinical cardiac laboratories, termed pulsed-field ablation (PFA), is gaining international momentum among cardiac electrophysiology proceduralists for the non-thermal management of both atrial and ventricular tachyrhythmogenic substrates. One area of potential application for PFA is in the mitigation of ventricular tachycardia (VT) risk in the setting of ischemia-mediated myocardial fibrosis, as evidenced by recently published clinical case reports. The efficacy of tissue electroporation has been documented in other branches of science and medicine; however, ventricular PFA\'s potential advantages and pitfalls are less understood. This comprehensive review will briefly summarize the pathophysiological mechanisms underlying VT and then summarize the pre-clinical and adult clinical data published to date on PFA\'s effectiveness in treating monomorphic VT. These data will be contrasted with the effectiveness ascribed to thermal cardiac ablation modalities to treat VT, namely radiofrequency energy and liquid nitrogen-based cryoablation.
摘要：
在临床心脏实验室中使用基于导管的不可逆电穿孔，称为脉冲场消融（PFA），在心房和心室节律性基质的非热管理方面，心脏电生理学程序家正在获得国际动力。PFA的一个潜在应用领域是在缺血介导的心肌纤维化背景下缓解室性心动过速（VT）风险。最近发表的临床病例报告证明了这一点。组织电穿孔的功效已在其他科学和医学分支中得到证明；然而，人们对心室PFA的潜在优势和缺陷了解较少。本综述将简要总结室性心动过速的病理生理机制，然后总结迄今为止发表的关于PFA治疗单形性室性心动过速的临床前和成人临床数据。这些数据将与心脏热消融术治疗室性心动过速的有效性进行对比。即射频能量和液氮冷冻消融。
