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J Vasc Interv Radiol. 2018 Jun;29(6):893-898.e4. doi: 10.1016/j.jvir.2017.12.019. Epub 2018 Apr 6.

Reduction of Muscle Contractions during Irreversible Electroporation Therapy Using High-Frequency Bursts of Alternating Polarity Pulses: A Laboratory Investigation in an Ex Vivo Swine Model.

Author information

1
Department of Radiation Oncology and Division of Radiation Physics, Stanford University Medical Center, Stanford, California; University of North Carolina/North Carolina State University Joint Department of Biomedical Engineering, 4130 Engineering Building III, Campus Box 7115, Raleigh, NC 27695. Electronic address: mikesano@med.unc.edu.
2
Department of Urology, Stanford University Medical Center, Stanford, California.
3
Department of Radiation Oncology and Division of Radiation Physics, Stanford University Medical Center, Stanford, California.
4
Department of Radiology, Stanford University, Stanford, California.
5
Department of Radiology and Division of Vascular and Interventional Radiology, Stanford University Medical Center, Stanford, California; Department of Radiology, Stanford University Medical Center, Stanford, California.

Abstract

PURPOSE:

To compare the intensity of muscle contractions in irreversible electroporation (IRE) treatments when traditional IRE and high-frequency IRE (H-FIRE) waveforms are used in combination with a single applicator and distal grounding pad (A+GP) configuration.

MATERIALS AND METHODS:

An ex vivo in situ porcine model was used to compare muscle contractions induced by traditional monopolar IRE waveforms vs high-frequency bipolar IRE waveforms. Pulses with voltages between 200 and 5,000 V were investigated, and muscle contractions were recorded by using accelerometers placed on or near the applicators.

RESULTS:

H-FIRE waveforms reduced the intensity of muscle contractions in comparison with traditional monopolar IRE pulses. A high-energy burst of 2-μs alternating-polarity pulses energized for 200 μs at 4,500 V produced less intense muscle contractions than traditional IRE pulses, which were 25-100 μs in duration at 3,000 V.

CONCLUSIONS:

H-FIRE appears to be an effective technique to mitigate the muscle contractions associated with traditional IRE pulses. This may enable the use of voltages greater than 3,000 V necessary for the creation of large ablations in vivo.

PMID:
29628296
DOI:
10.1016/j.jvir.2017.12.019
[Indexed for MEDLINE]

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