Irreversible electroporation for the treatment of cardiac arrhythmias.

INTRODUCTION: Cardiac ablation is an established treatment modality for the management of patients with cardiac arrhythmias. Current approaches to cardiac ablation employ thermal based energy to achieve lesions (damage) within the heart. There are many shortcomings and limitations of thermal based approaches. Electroporation (DC energy) is a non-thermal alternative approach to ablation that has shown significant promise in animal studies. Areas covered: An extensive review of the literature on the application of electroporation for ablation (both cardiac and collateral cardiac tissue) was undertaken. This review explores irreversible electroporation as a cardiac ablation modality. Specifically, it focuses and explains the biophysics of electroporation, the limitations of current thermal based approaches and examines the current data published on electroporation cardiac ablation. Expert commentary: Electroporation is a fast-growing novel ablation modality that has many advantages over current thermal based approaches. Current research in animal models shows its can be safely and efficaciously applied to the heart. Although further research is required, electroporation represents an appealing option for the ablation cardiac arrhythmias.