Opportunities and Challenges in Catheter-Based Irreversible Electroporation for Ventricular Tachycardia

Repp, Matthew Leonard; Chinyere, Ikeotunye Royal

doi:10.3390/pathophysiology31010003

Cited by 4 publications

(1 citation statement)

References 70 publications

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“…Applications for PFA include both atrial and ventricular arrhythmogenic substrate management. Though first described [1] and clinically approved in Europe [63] for atrial substrate modification, preclinical ventricular PFA data have suggested more favorable and homogeneous lesion characteristics in both normal and scarred ventricular myocardium [64][65][66][67] . However, additional preclinical and clinical evaluation is still necessary to clarify this potential advantage, relative to thermal catheter-based ablation techniques, namely radiofrequency energy.…”

Section: Efficacy and Coronary Artery Spasm/stenosismentioning

confidence: 99%

Cardiac blood vessels and irreversible electroporation: findings from pulsed field ablation

Chinyere,

Mori,

Hutchinson

2024

Vessel Plus

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The clinical use of irreversible electroporation in invasive cardiac laboratories, termed pulsed field ablation (PFA), is gaining early enthusiasm among electrophysiologists for the management of both atrial and ventricular arrhythmogenic substrates. Though electroporation is regularly employed in other branches of science and medicine, concerns regarding the acute and permanent vascular effects of PFA remain. This comprehensive review aims to summarize the preclinical and adult clinical data published to date on PFA’s effects on pulmonary veins and coronary arteries. These data will be contrasted with the incidences of iatrogenic pulmonary vein stenosis and coronary artery injury secondary to thermal cardiac ablation modalities, namely radiofrequency energy, laser energy, and liquid nitrogen-based cryoablation.

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Section: Efficacy and Coronary Artery Spasm/stenosismentioning

confidence: 99%

Cardiac blood vessels and irreversible electroporation: findings from pulsed field ablation

Chinyere,

Mori,

Hutchinson

2024

Vessel Plus

Self Cite

View full text Add to dashboard Cite

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Scar-Related Ventricular Tachycardia: Pathophysiology, Diagnosis, and Management

Biswas,

Kapoor,

Maheta

et al. 2024

Cardiology in Review

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Scar-related ventricular tachycardia (VT) commonly results from scarring in the myocardium, principally produced by antecedent myocardial infarction, cardiomyopathy, or prior cardiac surgery. The resultant arrhythmogenic substrate from scarred tissue and the alteration of normal cardiac electrical conduction predispose patients to reentrant circuits, followed by VT. This literature review synthesizes current research on pathophysiology, diagnostic methods, and treatment modalities of scar-related VT. The primary contents of the review are descriptions of the mechanisms through which myocardial fibrosis results in VT, clinical presentations of the condition, and advanced diagnostic techniques, including electrophysiological studies and mapping. Furthermore, the review outlines the various management strategies, such as implantable cardioverter-defibrillators, catheter ablation, stereotactic arrhythmia radioablation, and surgical ablation. The discussion also includes emerging therapeutics, such as gene therapy, artificial intelligence, and precision medicine in managing scar-related VT, emphasizing the ongoing advancements aimed at improving patient outcomes.

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Pulsed Field Ablation and Neurocardiology: Inert to Efferents or Delayed Destruction?

Chang,

Arbogast,

Chinyere

2024

Rev. Cardiovasc. Med.

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Background: The therapeutic use of irreversible electroporation in clinical cardiac laboratories, termed pulsed field ablation (PFA), is gaining pre-regulatory approval momentum among rhythm specialists for the mitigation of arrhythmogenic substrate without increased procedural risk. Though electroporation has been utilized in other branches of science and medicine for decades, apprehension regarding all the possible off-target complications of PFA have yet to be thoroughly identified and investigated. Methods: This brief review will summarize the preclinical and adult clinical data published to date on PFA’s effects on the autonomic system that interplays closely with the cardiovascular system, termed the neurocardiovascular system. These data are contrasted with the findings of efferent destruction secondary to thermal cardiac ablation modalities, namely radiofrequency energy and liquid nitrogen-based cryoablation. Results: In vitro neurocardiology findings, in vivo neurocardiology findings, and clinical neurocardiology findings to date nearly unanimously support the preservation of a critical mass of perineural structures and extracellular matrices to allow for long-term nervous regeneration in both cardiac and non-cardiac settings. Conclusions: Limited histopathologic data exist for neurocardiovascular outcomes post-PFA. Neuron damage is not only theoretically possible, but has been observed with irreversible electroporation, however regeneration is almost always concomitantly described.

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Opportunities and Challenges in Catheter-Based Irreversible Electroporation for Ventricular Tachycardia

Cited by 4 publications

References 70 publications

Cardiac blood vessels and irreversible electroporation: findings from pulsed field ablation

Cardiac blood vessels and irreversible electroporation: findings from pulsed field ablation

Scar-Related Ventricular Tachycardia: Pathophysiology, Diagnosis, and Management

Pulsed Field Ablation and Neurocardiology: Inert to Efferents or Delayed Destruction?

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