New method for treating the cardiac arrhythmias through electroporation

UL FE
Date of publication:
Slovenian scientists have contributed significantly to the development of treating heart arrhythmia using electroporation. This involves a procedure of ablation of the heart muscle with high-voltage electric pulses, in which researchers from the Faculty of Electrical Engineering of the University of Ljubljana under the leadership of Professor Damijan Miklavčič are collaborating with the American company Medtronic, one of the leading medical equipment companies in the world. The results of the clinical study were presented at the beginning of March by Dr. Atul Verma, head of clinical research at McGill University in Montreal, Canada, at the congress of the American College of Cardiology in New Orleans, USA.
Faster and equally effective method of treating heart arrhythmia
The study “Pulsed AF”, which involved 383 patients, was conducted in nine countries at 41 locations. The procedure was performed by 67 interventional cardiologists electrophysiologists. The purpose of this study and the primary analysis of results was to determine the safety of the new procedure and its effectiveness in a period of one year from the index procedure. The new method of ablation in this way underwent successful clinical testing. The effectiveness of the new ablation method using electroporation is the same as in comparable clinical studies using radiofrequency ablation and cryoablation, with the therapy also named Pulsed Field Ablation using electroporation being significantly faster. It is noteworthy that as many as 61 of the 67 interventional cardiologists who successfully performed the procedure had no previous experience with the system that was used, indicating the relative simplicity of the procedure. Detailed results of the study were published in the distinguished journal Circulation, which publishes research papers, review articles and other content related to cardiovascular health.
Electroporation procedure is significantly safer
Disturbance of the heart rhythm, called atrial fibrillation (AF), is a growing global health problem that requires early, safe and effective treatment. The gold standard for treatment is catheter ablation aimed at electrically isolating the pulmonary veins of the left atrium, for which radiofrequency and cryoablation are most commonly used. The new development, which has been successfully tested in a clinical setting, is the use of electroporation, which is a method for increasing the permeability of the cell membrane. It is already used to treat tumours, in gene therapy, biotechnology, food technology and environmental technologies. The new procedure of cardiac ablation uses irreversible electroporation, whereby the interventional cardiologist destroys part of the tissue that causes arrhythmia. Destruction of the cell is a consequence of electroporation of the cell membrane, and in contrast to the currently used thermal methods for destroying tissue, it does not require excessive heating (or freezing) of tissue. With thermal methods it is hard to control the spread of heat through the heart wall and into surrounding tissue, which can potentially lead to damage of critical tissues such as the oesophagus and phrenic nerve. For this very reason the method of ablation using electroporation is significantly safer.
The University of Ljubljana’s Faculty of Electrical Engineering and Professor Damijan Miklavčič are world leaders in the field of electroporation. They have been collaborating with Medtronic, the biggest manufacturer of medical devices in the world, since 2015 on the development of catheter cardiac ablation based on electroporation.
You can read more about this important scientific achievement in the following two articles:
The power and potential of electroporation: https://news.medtronic.com/the-power-and-potential-of-electroporation-newsroom
Development of pulsed field ablation: https://www.medtronic.com/us-en/c/cardiac-rhythm/pulsed-field-ablation.html?cmpid=mdtcom_pfa_vanity_url_CV_CAS_PulsedFieldAblation_FY23.