Breakthrough electroporation in heart muscle treatment

Slovenian scientists have made a significant contribution to the development of electroporation therapy for cardiac arrhythmias. This is a procedure that ablates the heart muscle with high-voltage electrical pulses, in which researchers, using Faculty of Electrical Engineering, University of Ljubljana led by Professor Damijan Miklavčič, are working with the American company Medtronic, one of the world's leading medical equipment companies. The results of the clinical study were presented by Dr Atul Verma, clinical research leader from McGill University, Montreal, Canada, on Monday, 6 March, at the American College of Cardiology Congress in New Orleans, USA.

New treatment for cardiac arrhythmia is as effective and even faster

The "Pulsed AF" study, involving 383 patients, was conducted in nine countries at 41 sites. The catheter procedure was performed by 67 cardiologist electrophysiologists. The purpose of this study and the primary outcome analysis was to determine the safety of the new procedure and its efficacy over a 1-year follow-up period. The new ablation modality was thus successfully tested clinically. The efficacy of the new ablation method with electroporation is equivalent to comparable clinical studies with radiofrequency ablation and cryoablation, with electroporation therapy being significantly faster. Interestingly, 61 of the 67 cardiac electrophysiologists who successfully performed the procedure had no previous experience with the catheter used, indicating the relative simplicity of the procedure. The detailed results of the study have been published in Circulation, a reputable journal that publishes research papers, review articles and other content related to cardiovascular health.

The electroporation method is significantly safer and faster

A heart rhythm disorder called atrial fibrillation (AF) is a growing global health problem that requires early, safe and effective treatment. The gold standard treatment is catheter ablation with the aim of electrically isolating the pulmonary veins from the left atrium, for which radiofrequency and cryoablation are most commonly used. However, a new technique that has been successfully tested clinically is the use of electroporation, which is a method to increase the permeability of the cell membrane. It is used in tumour treatment, gene therapy, biotechnology, food technology and environmental technologies. The new cardiac ablation procedure uses irreversible electroporation, whereby the cardiologist removes the part of the tissue causing the arrhythmia. The destruction of the cells is caused by electroporation of the cell membrane and, unlike the thermal methods used so far, does not require excessive heating (or freezing) of the tissue to destroy the tissue. This is what makes the electroporation ablation method significantly safer.

The University of Ljubljana, Faculty of Electrical Engineering and Professor Damijan Miklavčič are world leaders in the field of electroporation. Since 2015, they have been working with Medtronic, the world's largest medical device manufacturer, to develop catheter-based cardiac ablation based on electroporation.

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