Nonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model

Background Esophageal ulceration and fistula are severe complications of pulmonary vein isolation using thermal ablation. Nonthermal irreversible electroporation (NTIRE) is a promising new technology for pulmonary vein isolation in patients with atrial fibrillation. NTIRE ablation technology has bee...

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Autores principales:	Yue Song, Jingjing Zheng, Lianhui Fan
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	ablation esophagus irreversible electroporation tissue regeneration Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/5ba14d013b5d47d1bb873e5f348c5605
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spelling	oai:doaj.org-article:5ba14d013b5d47d1bb873e5f348c56052021-11-16T10:22:44ZNonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model10.1161/JAHA.120.0207312047-9980https://doaj.org/article/5ba14d013b5d47d1bb873e5f348c56052021-11-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.120.020731https://doaj.org/toc/2047-9980Background Esophageal ulceration and fistula are severe complications of pulmonary vein isolation using thermal ablation. Nonthermal irreversible electroporation (NTIRE) is a promising new technology for pulmonary vein isolation in patients with atrial fibrillation. NTIRE ablation technology has been used to treat atrial fibrillation; however, the effects of NTIRE on esophageal tissue have not been clearly described. Methods and Results A typical NTIRE electrical protocol was directly applied to esophagi in 84 New Zealand rabbits. Finite element modeling and histological analysis with 120 slices were used to analyze electric field intensity distribution and subsequent tissue changes. A parameter combination of 2000 V/cm multiplied by 90 pulses output is determined to be an effective ablation parameters combination. Within 16 weeks after ablation, no obvious lumen stenosis, epithelial erythema, erosion, ulcer, or fistula was observed in the esophageal tissue. NTIRE effectively results in esophageal cell ablation to death, and subsequently, signs of recovery gradually appear: creeping replacement and regeneration of epithelial basal cells, repair and regeneration of muscle cells, structural remodeling of the muscle layer, and finally the restoration of clear anatomical structures in all layers. Conclusions Monophasic, bipolar NTIRE delivered using plate electrodes in a novel esophageal injury model demonstrates no histopathologic changes to the esophagus at 16 weeks. Data of this study suggest that electroporation ablation is a safe modality for pulsed electroporation ablation near the esophagus.Yue SongJingjing ZhengLianhui FanWileyarticleablationesophagusirreversible electroporationtissue regenerationDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 22 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ablation esophagus irreversible electroporation tissue regeneration Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	ablation esophagus irreversible electroporation tissue regeneration Diseases of the circulatory (Cardiovascular) system RC666-701 Yue Song Jingjing Zheng Lianhui Fan Nonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model
description	Background Esophageal ulceration and fistula are severe complications of pulmonary vein isolation using thermal ablation. Nonthermal irreversible electroporation (NTIRE) is a promising new technology for pulmonary vein isolation in patients with atrial fibrillation. NTIRE ablation technology has been used to treat atrial fibrillation; however, the effects of NTIRE on esophageal tissue have not been clearly described. Methods and Results A typical NTIRE electrical protocol was directly applied to esophagi in 84 New Zealand rabbits. Finite element modeling and histological analysis with 120 slices were used to analyze electric field intensity distribution and subsequent tissue changes. A parameter combination of 2000 V/cm multiplied by 90 pulses output is determined to be an effective ablation parameters combination. Within 16 weeks after ablation, no obvious lumen stenosis, epithelial erythema, erosion, ulcer, or fistula was observed in the esophageal tissue. NTIRE effectively results in esophageal cell ablation to death, and subsequently, signs of recovery gradually appear: creeping replacement and regeneration of epithelial basal cells, repair and regeneration of muscle cells, structural remodeling of the muscle layer, and finally the restoration of clear anatomical structures in all layers. Conclusions Monophasic, bipolar NTIRE delivered using plate electrodes in a novel esophageal injury model demonstrates no histopathologic changes to the esophagus at 16 weeks. Data of this study suggest that electroporation ablation is a safe modality for pulsed electroporation ablation near the esophagus.
format	article
author	Yue Song Jingjing Zheng Lianhui Fan
author_facet	Yue Song Jingjing Zheng Lianhui Fan
author_sort	Yue Song
title	Nonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model
title_short	Nonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model
title_full	Nonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model
title_fullStr	Nonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model
title_full_unstemmed	Nonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model
title_sort	nonthermal irreversible electroporation to the esophagus: evaluation of acute and long‐term pathological effects in a rabbit model
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/5ba14d013b5d47d1bb873e5f348c5605
work_keys_str_mv	AT yuesong nonthermalirreversibleelectroporationtotheesophagusevaluationofacuteandlongtermpathologicaleffectsinarabbitmodel AT jingjingzheng nonthermalirreversibleelectroporationtotheesophagusevaluationofacuteandlongtermpathologicaleffectsinarabbitmodel AT lianhuifan nonthermalirreversibleelectroporationtotheesophagusevaluationofacuteandlongtermpathologicaleffectsinarabbitmodel
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Nonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model

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