Pulsed electrical field (PEF) energy is a promising technique for catheter ablation of cardiac arrhythmias. In this article, the key aspects that need to be considered for safe and effective PEF delivery are reviewed, and their impact on clinical feasibility is discussed. The most important benefit of PEF appears to be the ability to kill cells through mechanisms that do not alter stromal proteins, sparing sensitive structures to improve safety, without sacrificing cardiomyocyte ablation efficacy. Many parameters affect PEF treatment outcomes, including pulse intensity, waveform shape, and number of pulses, as well as electrode configuration and geometry. These physical and electrical characteristics must be titrated carefully to balance target tissue effects with collateral implications (muscle contraction, temperature rise, risk of electrical arcing events). It is important to note that any combination of parameters affecting PEF needs to be tested for clinical efficacy and safety. Applying PEF clinically requires knowledge of the fundamentals of this technology to exploit its opportunities and generate viable, durable health improvements for patients.

中文翻译：

---

脉冲电场消融入门

脉冲电场 (PEF) 能量是一种很有前途的心律失常导管消融技术。在本文中，回顾了安全有效的 PEF 输送需要考虑的关键方面，并讨论了它们对临床可行性的影响。PEF 最重要的好处似乎是能够通过不改变基质蛋白的机制杀死细胞，保留敏感结构以提高安全性，同时不牺牲心肌细胞消融功效。许多参数会影响 PEF 治疗结果，包括脉冲强度、波形形状和脉冲数量，以及电极配置和几何形状。必须仔细调整这些物理和电气特性，以平衡目标组织效应与附带影响（肌肉收缩、温度升高、电弧事件的风险）。需要注意的是，任何影响 PEF 的参数组合都需要进行临床疗效和安全性测试。在临床上应用 PEF 需要了解该技术的基础知识，以利用其机会并为患者带来可行、持久的健康改善。