ArticleJournal of the American Heart Association2018
Elimination of Purkinje Fibers by Electroporation Reduces Ventricular Fibrillation Vulnerability.
Article in Journal of the American Heart Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.
- Irreversible electroporation for catheter-based cardiac ablation: a systematic review of the preclinical experience.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2019Pooled it
- Specific effects of Pulsed Field Ablation on the cardiac tissue, the nervous system and the conduction system in experimental and clinical studies.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Review
- Nanosecond pulse electric field treatment initiates mitochondrial apoptosis pathway by inducing mitochondrial morphological changes in myocardial cells.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Idiopathic Ventricular Fibrillation Triggered by Purkinje-Related Extrasystoles: State-of-the-Art and Novel Therapeutic Approaches.Journal of cardiovascular electrophysiology · 2026Review
- Mapping and ablation of ventricular fibrillation substrate.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
- Novel insights into the substrate involved in maintenance of ventricular fibrillation: results from continuous multipolar mapping in a canine model.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Pulsed field ablation for ventricular arrhythmias: From mechanistic foundations to clinical translation.Heart rhythm O2 · 2026Review
- Pulsed field ablation of ventricular arrhythmias arising from intracavitary structures: insights from a clinical case series.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Empirical disconnection of left posterior fascicle: a new paradigm in catheter ablation of ventricular fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Fascicular/Purkinje Tissue Colocalized With Scar in Cardiomyopathy Patients Undergoing Ventricular Fibrillation Ablation.Pacing and clinical electrophysiology : PACE · 2025Observational
- Pulsed Field Ablation: A Review of Preclinical and Clinical Studies.Bioengineering (Basel, Switzerland) · 2025Review
- Complexity and Perplexity of Pulsed Field Ablation: An Engineering Perspective.Arrhythmia & electrophysiology review · 2025Review
- Idiopathic Ventricular Fibrillation: Substrates, Mechanisms and Treatment.Arrhythmia & electrophysiology review · 2025Review
- Contemporary Trends in Pulsed Field Ablation for Cardiac Arrhythmias.Journal of cardiovascular development and disease · 2024Review
- Pulsed Field Ablation: A Comprehensive Update.Journal of clinical medicine · 2024Review
- Impact of Pulsed Electric Field Ablation on His Bundle Conduction: A Preclinical Canine Study.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- Preclinical evaluation of reversible pulsed electrical field: electrophysiological and histological assessment of myocardium.Frontiers in cardiovascular medicine · 2024Article
- Potential Application of Pulsed Field Ablation in Ventricular Arrhythmias.Medicina (Kaunas, Lithuania) · 2023Review
- Differential effect of high-frequency electroporation on myocardium vs. non-myocardial tissues.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Determination of lethal electric field threshold for pulsed field ablation inFrontiers in cardiovascular medicine · 2023Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
Background The Purkinje network appears to play a pivotal role in the triggering as well as maintenance of ventricular fibrillation. Irreversible electroporation ( IRE ) using direct current has shown promise as a nonthermal ablation modality in the heart, but its ability to target and ablate the Purkinje tissue is undefined. Our aim was to investigate the potential for selective ablation of Purkinje/fascicular fibers using IRE . Methods and Results In an ex vivo Langendorff model of canine heart (n=8), direct current was delivered in a unipolar manner at various dosages from 750 to 2500 V, in 10 pulses with a 90-μs duration at a frequency of 1 Hz. The window of ventricular fibrillation vulnerability was assessed before and after delivery of electroporation energy using a shock on T-wave method. IRE consistently eradicated all Purkinje potentials at voltages between 750 and 2500 V (minimum field strength of 250-833 V/cm). The ventricular electrogram amplitude was only minimally reduced by ablation: 0.6±2.3 mV ( P=0.03). In 4 hearts after IRE delivery, ventricular fibrillation could not be reinduced. At baseline, the lower limit of vulnerability to ventricular fibrillation was 1.8±0.4 J, and the upper limit of vulnerability was 19.5±3.0 J. The window of vulnerability was 17.8±2.9 J. Delivery of electroporation energy significantly reduced the window of vulnerability to 5.7±2.9 J ( P=0.0003), with a postablation lower limit of vulnerability=7.3±2.63 J, and the upper limit of vulnerability=18.8±5.2 J. Conclusions Our study highlights that Purkinje tissue can be ablated with IRE without any evidence of underlying myocardial damage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.