Abstract：
Pulsed-field ablation (PFA) is an emerging ablative technology that has been used successfully to eliminate cardiac arrhythmias. As a nonthermal technique, it has significant benefits over traditional radiofrequency ablation with improved target tissue specificity and reduced risk of adverse events during cardiac applications. We investigated whether PFA is safe for use in the stomach and whether it could modulate gastric slow waves. Female weaner pigs were fasted overnight before anesthesia was induced using tiletamine hydrochloride (50 mg·mL-1) and zolazepam hydrochloride (50 mg·mL-1) and maintained with propofol (Diprivan 2%, 0.2-0.4 mg·kg-1·min-1). Pulsed-field ablation was performed on their gastric serosa in vivo. Adjacent point lesions (n = 2-4) were used to create a linear injury using bipolar pulsed-field ablation consisting of 40 pulses (10 Hz frequency, 0.1 ms pulse width, 1,000 V amplitude). High-resolution electrical mapping defined baseline and postablation gastric slow-wave patterns. A validated five-point scale was used to evaluate tissue damage in hematoxylin and eosin-stained images. Results indicated that PFA successfully induced complete conduction blocks in all cases, with lesions through the entire thickness of the gastric muscle layers. Consistent postablation slow-wave patterns emerged immediately following ablation and persisted over the study period. Pulsed-field ablation induces rapid conduction blocks as a tool to modulate slow-wave patterns, indicating it may be suitable as an alternative to radiofrequency ablation.NEW & NOTEWORTHY Results show that pulsed-field ablation can serve as a gastric slow-wave intervention by preventing slow-wave propagation across the lesion site. Stable conduction blocks were established immediately following energy delivery, faster than previous examples of radiofrequency gastric ablation. Pulsed-field ablation may be an alternative for gastric slow-wave intervention, and further functional and posthealing studies are now warranted.
摘要：
脉冲场消融（PFA）是一种新兴的消融技术，已成功用于消除心律失常。作为非热技术,其具有优于传统射频消融的显著益处,具有改善的靶组织特异性和降低的心脏应用期间的不良事件风险。我们调查了PFA在胃中使用是否安全，以及它是否可以调节胃慢波。雌性断奶猪禁食过夜，然后使用盐酸替利塔明（50mgmL-1）和盐酸唑拉西泮（50mgmL-1）诱导麻醉，并用异丙酚维持（Diprivan2％，0.2‑0.4mgkg‑1min‑1)。在体内对其胃浆膜进行脉冲场消融。使用由40个脉冲组成的双极脉冲场消融（10Hz频率，0.1ms脉冲宽度，1000V振幅)。高分辨率电标测定义了基线和消融后胃慢波模式。在苏木精和曙红染色的图像中使用经过验证的五点量表来评估组织损伤。结果表明，PFA在所有情况下都成功诱导了完全传导阻滞，具有贯穿胃肌肉层整个厚度的病变。消融后立即出现一致的消融后慢波模式，并在研究期间持续存在。脉冲场消融引起快速传导阻滞，作为调节慢波模式的工具，表明它可能适合作为射频消融的替代方案。
