Pulsed-field ablation: an alternative ablative method for gastric electrophysiological intervention

Area of Science:

• Gastroenterology
• Medical Devices
• Electrophysiology

Background:

• Pulsed-field ablation (PFA) is an emerging nonthermal ablative technology with proven efficacy in cardiac arrhythmia treatment.
• Traditional radiofrequency ablation carries risks and limitations in target tissue specificity.
• Investigating PFA's safety and efficacy for gastric applications is crucial for developing new therapeutic strategies.

Purpose of the Study:

• To assess the safety of pulsed-field ablation (PFA) for gastric tissue.
• To determine if PFA can modulate gastric slow waves by inducing conduction blocks.
• To compare PFA's effectiveness with existing radiofrequency ablation methods.

Main Methods:

• PFA was performed on the gastric serosa of female weaner pigs under anesthesia.
• Linear lesions were created using bipolar PFA with specific pulse parameters (40 pulses, 10 Hz, 0.1 ms, 1,000 V).
• High-resolution electrical mapping and histological analysis (hematoxylin and eosin) evaluated tissue damage and conduction block.

Main Results:

• PFA successfully created full-thickness conduction blocks in the gastric muscle layers in all subjects.
• Consistent postablation slow-wave patterns emerged immediately and persisted throughout the study.
• Tissue damage assessment indicated PFA's safety profile for gastric applications.

Conclusions:

• Pulsed-field ablation is a safe and effective method for modulating gastric slow-wave patterns.
• PFA rapidly establishes conduction blocks, offering a potential advantage over radiofrequency ablation.
• Further studies are warranted to explore PFA's long-term functional outcomes and healing in gastric interventions.