脉冲电场消融在心律失常治疗中的应用及作用机制研究进展

Research progress on the application and mechanism of pulse electric field ablation in the treatment of arrhythmia

导管消融作为临床现阶段治疗心律失常的重要方式之一,其中脉冲电场消融属于一种存在高度组织选择性的新型消融方式,同时作为非热性的消融方式,其可提供高能瞬时的脉冲能量,传递到患者心肌细胞膜,形成不可逆电穿孔,导致细胞内容物排出,直接打破细胞内环境的稳定性,进而促进细胞死亡,同时减轻炎性反应。近年来,临床经不断研究,发现该方式与冷冻消融、射频消融相比,具备非接触消融、组织选择性、能量释放速度快、损伤效果好等优势,有望成为心律失常治疗的新能量来源。鉴于此,笔者现对脉冲电场消融在心律失常治疗中的应用及作用机制展开综述,旨在明确脉冲电场消融的临床应用价值,从而为心律失常患者提供更加安全、有效的治疗方法。

Catheter ablation,as one of the important methods for treating arrhythmia in clinical practice,is a new type of ablation with high tissue selectivity.As a non thermal ablation method,it can provide high-energy instantaneous pulse energy,which is transmitted to the patient’s myocardial cell membrane,forming irreversible electroporation,leading to the discharge of cellular contents,directly disrupting the stability of the intracellular environment,promoting cell death,and reducing inflammatory reactions.In addition,in recent years,continuous clinical research has found that compared with cryoablation and radiofrequency ablation,this method has advantages such as non-contact ablation,tissue selectivity,fast energy release speed,and good damage effect.It is expected to become a new source of energy for the treatment of arrhythmia.Therefore,the authors reviewed the application and mechanism of pulse electric field ablation in the treatment of arrhythmia,aiming to clarify the clinical application value of pulse electric field ablation and provide safer and more effective treatment methods for arrhythmia patients.