Absence of (sub-) acute cerebral events or lesions after electroporation ablation in the left-sided canine heart.

Abstract Background Irreversible electroporation (IRE) is a nonthermal ablation modality. A 200J application can create deep myocardial lesions, but gas bubbles are created at the ablation electrode. Cerebral effects of these bubbles are unknown. Objective To investigate gas microemboli-induced brain lesions after IRE and radiofrequency (RF) ablation to the left side of the canine heart, using MRI and histopathology. Methods In 11 canines, baseline cerebral MRI scans were performed. In 9 animals, after retrograde femoral artery access, 12±4 200J IRE applications were administered in the ascending aorta. In 2 animals, 30 minutes of irrigated 30-Watt RF ablation using 10-30 grams of contact force was applied in the left ventricle. At days 1 and 5 after ablation, MRI was repeated. Afterwards, the brain tissue was histopathologically examined. Results All ablations and follow-up were uneventful, intracardiac echography confirmed gas bubble formation after each IRE application. Neurological examination was normal. MRI scans were normal in all animals at day 1, and normal in 10/11 animals at day 5. In 1 animal, a single Conclusion MRI images alone or in combination with histological follow-up did not reveal treatment-related embolic events. Gross and microscopic pathology did not reveal evidence of treatment-related embolic events. Irreversible electroporation seems to be a safe ablation modality for the brain.