Work

Mitigating muscle contractions during pulsed field ablation by utilizing intersegment delays

Year: 2025

Type: article

Abstract: Pulsed field ablation (PFA) uses low energy electric fields to ablate soft tissues, such as cancerous tumors or aberrant heart muscle via irreversible electroporation (IRE). The primary mechanism of cell death is an induced electric potential across the cell membrane, creating long-lived pores. However, an induced transmembrane potential will also excite neurons, causing undesirable muscle contractions. Biphasic pulsing and higher frequency waveforms are effective nerve excitation mitigation strategies, but also limit treatment volume. Here, we utilize a single, extended delay between two symmetrical biphasic pulsing trains, called an intersegment delay (ISD), for reduced muscle contractions. An ISD of 250 μs was found to increase the threshold for nerve stimulation (66 V/cm vs 63 V/cm), leading to a ∼ 30 % decrease in physical acceleration, while not significantly impacting the lethal electric field threshold (769 V/cm vs 787 V/cm) compared to the continuous waveform. The refined electrical waveform design presented in this study mitigates muscle contractions without compromising ablation volume. Thus, introducing an ISD presents a refined approach to electroporation-based treatments, potentially enhancing their clinical utility.

Source: Bioelectrochemistry

DOI: 10.1016/j.bioelechem.2025.109049

Authors: Sabrina N. Campelo, Zaid S. Salameh, Kenneth N. Aycock, Melvin F. Lorenzo, John H. Rossmeisl, Rafael V. Davalos