科赫三角接触力相关脉冲场电穿孔的热分布,超越钙电穿孔。

IF 1.3
Pacing and clinical electrophysiology : PACE Pub Date : 2025-08-01 Epub Date: 2025-07-17 DOI:10.1111/pace.70013
Yiqi Lu, Huimin Chu, Rong Bai, Feifan Ouyang, Zhenyu Jia, Mingjun Feng, Xianfeng Du, Si Chen, Lipu Yu, Jiating Dai, Tingsha Du, Weidong Zhuo, Yijun Sun, Xinzhi Yu, Chenxu Luo, Caijie Shen
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引用次数: 0

摘要

背景:在临床环境中,接触力(CF)依赖的脉冲场电穿孔(PFE)可能产生组织加热,影响科赫三角(ToK)的连接节律。PFE也可能破坏钙稳态,引起钙电穿孔(CE)的焦耳加热。CF对ToK电极温度(ET)的PFE和CE的影响尚未得到验证。方法:将一根带ET探针的cf传感导管垂直放置于12头猪解剖后的ToK上。PFE应用于四组:低cf -氯化钙(CC, 5.0 mM;LCF-CC, 2-10 g),高CF-CC (HCF-CC, 11-50 g), lcf -盐水溶液(SS;CF-SS, 2-10 g), HCF-SS (11-50 g)。由(LCF-CC减去LCF-SS)和(HCF-SS减去LCF-SS)产生的ET变化在操作上分别被定义为主要的CE (DCE)和PEF (DPFE)成分。结果:与其他组相比,LCF-CC组出现直线骤升(AS)后骤降(SD)的时间-温度曲线较少(p < 0.05), DCE组△△SD- mt(对△SD- mt的抗性)更为突出(p < 0.2±0.5),p < 0.1±0.5,p >结论:体外模型显示两相ET变化(先上升后下降)与cf依赖性CE和PFE相关。CF显著调节ET动态,同时保持安全的热阈值。进一步的研究应该阐明这种双相模式如何影响体内条件下的连接节律产生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Thermal Profile of Contact Force Dependent Pulse Field Electroporation Beyond Calcium Electroporation at the Koch Triangle.

Background: Contact force (CF)-dependent pulse field electroporation (PFE) may generate tissue heating, affecting junctional rhythm at the triangle of Koch (ToK) in a clinical setting. PFE may also disrupt calcium homeostasis, causing calcium electroporation (CE) for some Joule heating. The impact of CF on PFE and CE for electrode temperature (ET) at the ToK has not been validated.

Methods: A CF-sensing catheter with an ET probe was positioned perpendicularly on dissected ToK from 12 swine. PFE was applied in four groups: low CF-calcium chloride (CC, 5.0 mM; LCF-CC, 2-10 g), high CF-CC (HCF-CC, 11-50 g), LCF-saline solution (SS; CF-SS, 2-10 g), and HCF-SS (11-50 g). ET changes derived from (LCF-CC minus LCF-SS) and (HCF-SS minus LCF-SS) was operationally defined as dominant CE (DCE) and PEF (DPFE) components, respectively.

Results: Fewer time-temperature curves with straight, abrupt surge (AS) followed by sudden descent (SD) were observed in LCF-CC versus other groups (p < 0.001). The delayed AS-maximal temperature (MT) curve is almost absent in the LCF-SS versus LCF-CC group (6.3% vs. 70.3%, p < 0.001). The highest △AS-MT was detected in HCF-CC and LCF-CC groups (4.3 ± 0.7°C vs. 4.3 ± 1.0°C, p = 0.37). △△AS-MT was larger from DCE than the DPFE effect (1.1 ± 1.0°C vs. 0.4 ± 0.4°C, p < 0.001). Although △SD-MT was similar in DCE and DPFE groups (p > 0.05), △△SD-MT (resistance to △SD-MT) was more prominent in DCE (0.2 ± 0.5 vs. -0.1 ± 0.5, p < 0.05). More extensive △SD-MT/duration was synchronously changed with short duration in LCF-CC or HCF-SS versus HCF-CC, and DCE group (p < 0.05).

Conclusions: The in vitro model showed biphasic ET changes (initial rise followed by decline) correlated with CF-dependent CE and PFE. CF significantly modulated ET dynamics while maintaining safe thermal thresholds. Further studies should clarify how this biphasic pattern affects junctional rhythm generation in vivo conditions.

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