Irreversible electroporation (IRE), an emerging alternative to thermal ablation, is a safe and effective treatment option for atrial fibrillation (AFib) patients, according to a new analysis published in Circulation: Arrhythmia and Electrophysiology.
“In the past two decades, radiofrequency- and cryo-ablation became standard techniques for ablation of AFib,” wrote first author Peter Loh, MD, PhD, of the department of cardiology at University Medical Center Utrecht in the Netherlands, and colleagues. “However, thermal ablation through conductive heating or cooling of myocardial tissue also revealed important disadvantages.”
IRE, the authors noted, is one potential treatment researchers have been exploring that could help clinicians avoid the drawbacks of thermal ablation. This first-in-human study explored the feasibility of using single pulse IRE for pulmonary vein (PV) isolation in 10 patients with symptomatic AFib.
Overall, the researchers reported, IRE was a success. All PVs were isolated and no PV reconnections occurred during the waiting period and adenosine testing. The mean procedure time was 148 minutes, the mean fluoroscopy time was just shy of 30 minutes and the mean ablation time was 44 minutes.
In addition, Loh et al. noted, “no periprocedural complications were observed.” One patient, however, did experience a prolonged admission because “additional diagnostics were performed due to the ST elevations observed during the procedure.”
“Single pulse IRE ablation is a promising new technique that allows rapid and safe PV isolation,” the authors wrote. “Ablation takes only a few milliseconds and the nonthermal character and tissue specificity of IRE ablation avoid most complications that are associated with thermally mediated radiofrequency and cryoablation. Single pulse IRE ablation can be regarded as safe and effective enough to design future clinical studies to further examine the efficacy and safety compared with other ablation techniques.”
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.