Cardiac electroporation: The promise of the unknown

Asirvatham, Samuel J.

doi:10.1111/jce.13466

Cited by 7 publications

(7 citation statements)

References 9 publications

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“…A novel integrated headphone stimulatory device can be used safely and effectively to improve and modulate autonomic tone while enjoying a musical experience, affirming the hypothesis with the exception of an emotional change [19].…”

Section: Discussionsupporting

confidence: 55%

Combined Auditory and Tragal Stimulation Headphone Effectively Increases Vagal Tone and Improves Short-Term Cognition

Asirvatham

2019

BJSTR

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The autonomic nervous system is responsible for many psychological and physiological phenomena. Music is known to influence the autonomic nervous system and provide many beneficial effects in both the body and the mind. The vagus nerve has also been stimulated to invoke similar beneficial effects. Since this procedure is invasive, the tragus nerve, which is the only input to the vagus, is ideal for autonomic modulation. While this effect has been demonstrated alone, the combination of music and tragal stimulation, two very similar interventions, has not been studied yet.Hypothesis: A modified headphone with combined stimulatory electrodes on the tragus will safely and effectively stimulate the vagus nerve while listening to music. Such combined stimulation will improve autonomic tone, cognition, and mood.Methods: Autonomic functions such as heart rate, blood pressure, heart rate variability, and electrodermal activity as well as cognition and emotions were recorded during various interventions. These interventions included music (major and minor chords), tragal simulation alone, and the combination of both.Results: All participants completed the experiment without any adverse effects. There was a statistically significant decrease in heart rate (p=0.038) and increase in heart rate variability (p=0.001) in response to tragal stimulation. The heart rate variability increase was more pronounced in females indicating previously unreported phenomena. Cognition improved significantly (p=0.008) with tragal stimulation and music combined. Conclusion:A novel integrated headphone stimulatory device can be used safely and effectively to improve and modulate autonomic tone and cognition while enjoying a musical experience.

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Section: Discussionsupporting

confidence: 55%

Combined Auditory and Tragal Stimulation Headphone Effectively Increases Vagal Tone and Improves Short-Term Cognition

Asirvatham

2019

BJSTR

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“…Irreversible electroporation (IRE) is a method of tissue ablation using microsecond pulses of direct current (DC) energy, which creates cell death by altering the stability of the cell membrane and disrupting the homeostasis of the cell 7, 8. While some small amount of heat may be created, the mechanism of cell death does not rely on heat formation, thus removing the need for high temperatures.…”

Section: Introductionmentioning

confidence: 99%

Intrapulmonary Vein Ablation Without Stenosis: A Novel Balloon‐Based Direct Current Electroporation Approach

Witt

Sugrue

Padmanabhan

et al. 2018

JAHA

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BackgroundCurrent thermal ablation methods for atrial fibrillation, including radiofrequency and cryoablation, have a suboptimal success rate. To avoid pulmonary vein (PV) stenosis, ablation is performed outside of the PV, despite the importance of triggers inside the vein. We previously reported on the acute effects of a novel direct current electroporation approach with a balloon catheter to create lesions inside the PVs in addition to the antrum. In this study, we aimed to determine whether the effects created by this nonthermal ablation method were associated with irreversible lesions and whether PV stenosis or other adverse effects occurred after a survival period.Methods and ResultsInitial and survival studies were performed in 5 canines. At the initial study, the balloon catheter was inflated to contact the antrum and interior of the PV. Direct current energy was delivered between 2 electrodes on the catheter in ECG‐gated 100 μs pulses. A total of 10 PVs were treated demonstrating significant acute local electrogram diminution (mean amplitude decrease of 61.2±19.8%). After the survival period (mean 27 days), computed tomography imaging showed no PV stenosis. On histologic evaluation, transmural, although not circumferential, lesions were seen in each treated vein. No PV stenosis or esophageal injury was present.ConclusionsIrreversible, transmural lesions can be created inside the PV without evidence of stenosis after a 27‐day survival period using this balloon‐based direct current ablation approach. These early data show promise for an ablation approach that could directly treat PV triggers in addition to traditional PV antrum ablation.

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“…Cardiac electroporation holds major promise for the treatment of such a complex overlay of myocardium and conduction system tissue. With the advantages of its selectivity, short duration, nonthermal nature, and the ability to modulate tissue reversibly as well as irreversibly, this energy modality may lend itself as ideal for selective and safe Purkinje tissue ablation . Furthermore, identification of the Purkinje signal itself can be difficult, especially given the associated myocardial signals with our current recording systems.…”

Section: Current Mapping and Ablation Tools And Strategies Are Suboptmentioning

confidence: 99%

“…With the advantages of its selectivity, short duration, nonthermal nature, and the ability to modulate tissue reversibly as well as irreversibly, this energy modality may lend itself as ideal for selective and safe Purkinje tissue ablation. [10][11][12] Furthermore, identification of the Purkinje signal itself can be difficult, especially given the associated myocardial signals with our current recording systems. Recording systems that have an increased dynamic range, as well as novel signal processing and filters for Purkinje tissue, may help decipher these high-frequency and low amplitude signals, and be a major advance in our quests for precise mapping and ablation of VF.…”

Section: Current Mapping and Ablation Tools And Strategies Are Suboptmentioning

confidence: 99%

Purkinje tissue modification and ventricular fibrillation

DeSimone

Asirvatham

2019

Pacing Clinical Electrophis

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Cardiac electroporation: The promise of the unknown

Cited by 7 publications

References 9 publications

Combined Auditory and Tragal Stimulation Headphone Effectively Increases Vagal Tone and Improves Short-Term Cognition

Combined Auditory and Tragal Stimulation Headphone Effectively Increases Vagal Tone and Improves Short-Term Cognition

Intrapulmonary Vein Ablation Without Stenosis: A Novel Balloon‐Based Direct Current Electroporation Approach

Purkinje tissue modification and ventricular fibrillation

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