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The effect of electroporation pulses on functioning of the heart
Barbara Mali1, Tomaz Jarm, Selma Corovic
1Laboratory of Biocybernetics, Faculty of Electrical Engineering, University of Ljubljana, Trzaska 25, 1000, Ljubljana, Slovenia. barbara.mali@fe.uni-lj.si
Abstract:
Electrochemotherapy is an effective antitumor treatment currently applied to cutaneous and subcutaneous tumors. Electrochemotherapy of tumors located close to the heart could lead to adverse effects, especially if electroporation pulses were delivered within the vulnerable period of the heart or if they coincided with arrhythmias of some types. We examined the influence of electroporation pulses on functioning of the heart of human patients by analyzing the electrocardiogram. We found no pathological morphological changes in the electrocardiogram; however, we demonstrated a transient RR interval decrease after application of electroporation pulses. Although no adverse effects due to electroporation have been reported so far, the probability for complications could increase in treatment of internal tumors, in tumor ablation by irreversible electroporation, and when using pulses of longer durations. We evaluated the performance of our algorithm for synchronization of electroporation pulse delivery with electrocardiogram. The application of this algorithm in clinical electroporation would increase the level of safety for the patient and suitability of electroporation for use in anatomical locations presently not accessible to existing electroporation devices and electrodes.
Insights
Electrochemotherapy (ECT) is safe for skin tumors. While ECT pulses caused a brief heart rate increase in patients, no lasting damage was observed, improving treatment safety.
Area of Science:
- Cardiology
- Oncology
- Biomedical Engineering
Background:
- Electrochemotherapy (ECT) effectively treats cutaneous and subcutaneous tumors.
- Potential cardiac adverse effects exist for ECT near the heart, especially during vulnerable periods or with arrhythmias.
Purpose of the Study:
- To investigate the impact of electroporation pulses on human cardiac function using electrocardiogram (ECG) analysis.
- To evaluate an algorithm for synchronizing electroporation delivery with ECG to enhance patient safety.
Main Methods:
- Analysis of electrocardiograms (ECGs) from human patients undergoing electrochemotherapy.
- Evaluation of a novel algorithm for synchronizing electroporation pulse delivery with ECG.
Main Results:
- No pathological morphological changes were observed in ECGs post-electroporation.
- A transient decrease in RR interval (heart rate increase) was detected immediately after electroporation pulse delivery.
Conclusions:
- ECT appears safe regarding cardiac morphology, with transient heart rate changes observed.
- An ECG-synchronized algorithm can improve patient safety and expand ECT applications to internal tumors and new anatomical sites.
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