The electrical foci that cause atrial fibrillation are located, in the vast majority of cases, at the origin of the pulmonary veins in the left atrium. The principle of treatment is therefore to electrically isolate the pulmonary vein region from the rest of the left atrium. This treatment is performed during a procedure carried out under general anesthesia or conscious sedation. Until now, the techniques used have been based on thermal energy: radiofrequency ablation or cryotherapy. The principle of electroporation treatment is to create tissue damage using high-voltage micro-electrical shocks.
The advantage of this technique lies in its tissue specificity. The energy level required to damage a cell differs between a muscle, a nerve, and a blood vessel. This allows for the delivery of an effective energy level to the tissues being treated while respecting the surrounding anatomical structures.
The use of this technique in cardiology , and more specifically in electrophysiology, is recent but very promising. It allows for safer patient care, better recovery, and faster intervention. It has the advantage of not causing damage to non-cardiac collateral tissues, whereas current thermal ablation techniques can affect neighboring tissues, particularly the esophagus and the phrenic nerve.
However, some arrhythmias require different treatment, for which radiofrequency or cryotherapy remain the most appropriate.
Pulsed electric field ablation therefore represents an additional tool for the treatment of complex cardiac arrhythmias, including atrial fibrillation.
