Cardiac impact of high-frequency irreversible electroporation using an asymmetrical waveform on liver in vivo

BMC Cardiovascular Disorders

Jingjing Wang¹  Hongmei Gao¹  Xiao Zhang²  Yueyong Xiao²  Xiaobo Zhang²  Jing Li³ 

[1]Department of Critical Care Medicine, Tianjin First Center Hospital, 300192, Tianjin, China

[2]Department of Radiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China

[3]Department of Radiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China

[4]Department of MRI, Affiliated Hospital, Logistics University of Chinese Peoples Armed Police Forces, 300162, Tianjin, China

关键词: High-frequency irreversible electroporation;    Irreversible electroporation;    Liver ablation;    Arrhythmia;    Cardiac injury;   

DOI  :  10.1186/s12872-021-02412-9

来源: Springer

【 摘 要 】

BackgroundHigh-Frequency Irreversible Electroporation (H-FIRE) is a novel technology for non-thermal ablation. Different from Irreversible electroporation (IRE), H-FIRE delivers bipolar electrical pulses without muscle contraction and does not cause electrolysis. Currently, little is known regarding the cardiac safety during the administration of H-FIRE on liver. The aim of this study was to evaluate the changes of electrocardiogram (ECG) and biomarkers of cardiac damage during asymmetrical waveform of H-FIRE therapy in vivo.MethodsThe swines (n = 7) in IRE group, which used 100 pulses (2200 V, 100–100 μs configuration), were administrated with muscle relaxant under anesthesia. In the absence of muscle relaxant, 7 swines in H-FIRE group were performed with 2400 pulses (3000 V, 5–3–3–5 μs configuration). Midazolam (0.5 mg/kg) and xylazine hydrochloride (20 mg/kg) were given to induce sedation, followed by Isoflurane (2.5%, 100% oxygen, 3 L/min) to maintain sedation in all the swines. Limb lead ECG recordings were analyzed by two electrophysiologists to judge the arrhythmia. Cardiac and liver tissue was examined by pathology technique.ResultsThe ablation zones were larger in H-FIRE than IRE. Both IRE and H-FIRE did not affect the autonomous cardiac rhythm. Even when the electrical signal of IRE and H-FIRE fell on ventricular vulnerable period. Moreover, cTnI in IRE group showed an increase in 4 h after ablation, and decreased to baseline 72 h after ablation. However, cTnI showed no significant change during the administration of H-FIRE.ConclusionsThe study suggests an asymmetrical waveform for H-FIRE is a promising measure for liver ablation. The results were based on normal liver and the swines without potential cardiac diseases. With the limitations of these facts, asymmetrical waveform for H-FIRE of liver tissue seems relatively safe without major cardiac complications. The safety of asymmetrical waveform for H-FIRE needs to evaluate in future.

【 授权许可】

CC BY