An Examination of the Cardiothoracic Tissue Biophysical Response to Electroporation Therapies

Abstract

Atrial fibrillation (AF) is a disease that affects an estimated 2.7 to 6.1 million people in the United States alone. Currently there are two primary ways to treat the disease: drug or ablation therapy. Ablation therapy is used to kill or isolate the cardiac tissue that is causing abnormal cardiac conduction. The two primary ablation technologies used are radiofrequency ablation (RF) and cryoablation (Cryo). While both technologies have shown clinical efficacy, they are not without their drawbacks. Both RF and Cryo are thermal ablation modalities that cause cell death by either heating or cooling the tissue. Due to variations in anatomy, blood flow, and how the energy is applied, complications can occur when the thermal energy propagates beyond the intended target zone. This may result in collateral damage, such as phrenic nerve injury or atria-esophageal fistula. Electroporation is a new technology that is being investigated as a novel way to treat cardiac arrhythmias. It uses short, high voltage, DC electrical pulses to disrupt the cell membrane that can lead to cell death. The work presented here quantifies the biophysical responses of electroporation on different cardiothoracic tissue types. The functional response of skeletal, smooth, and cardiac muscle was evaluated using isolated muscle baths. Following this, a uniaxial pull test was performed to evaluate any effects on tissue integrity. Phrenic nerve functional response to electroporation was evaluated with elicited compound action potential recordings. The complete dataset provides an understanding of how to target different tissue types which can be useful when developing therapeutic protocols or medical device design.