A Conceivable Mechanism Responsible for the Synergy of High and Low Voltage Irreversible Electroporation Pulses
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Irreversible electroporation (IRE), is a new non-thermal tissue ablation technology in which brief high electric field pulses are delivered across the target tissue to induce cell death by irreversible permeabilization of the cell membrane. A deficiency of conventional IRE is that the ablation zone is relatively small, bounded by the irreversible electroporation isoelectric field margin. In the previous studies we have introduced a new treatment protocol that combines few short high voltage (SHV) pulses with long low-voltage (LLV) pulses. In the previous studies, we also have shown that the addition of few SHV pulses increases by almost a factor of two the area ablated by a protocol that employs only the LLV pulses. This study employs potato and gel phantom to generate a plausible explanation for the mechanism. The study provides circumstantial evidence that the mechanism involved is the production of electrolytic compounds by the LLV pulse sequence, which causes tissue ablation beyond the margin of the irreversible electroporation isoelectric field generated by the SHV pulses, presumable to the reversible electroporation isoelectric field margin generated by the SHV pulses.
KeywordsFocal ablation Electroporation Electrolysis High and low voltage pulses Synergistic effect
The authors thank the Mechanical Engineering Department at UC Berkeley, China Scholarship Council (CSC), the National Natural Science Foundation of China (51877022), and the National Natural Science Foundation of China (51807016) for financial support.
Conflict of interest
BR reports that he is a co-inventor in a patent application entitled “Methods, Systems, and Apparatuses for Tissue Ablation Using Electrolysis and Permeabilization”—US 2016 0296269 A1. The other authors have no conflicts to report.
- 2.Bertacchini, C., P. M. Margotti, E. Bergamini, et al. Irreversible electroporation systems for clinical use. In: Irreversible Electroporation. Berlin: Springer, 2010, pp. 255–272.Google Scholar
- 9.Gehl, J., and G. Sersa. Electrochemotherapy and its clinical applications. In: Handbook of Electroporation, edited by D. Miklavcic. New York: Springer, 2017, pp. 1771–1786.Google Scholar
- 18.Martin, R. C. G. Use of irreversible electroporation in unresectable pancreatic cancer. Hepatobiliary Surg. Nutr. 4(3):211–215, 2015.Google Scholar
- 23.Mir, L. M., et al. Electrochemotherapy, a new antitumor treatment: first clinical trial. C. R. Acad. Sci. Ser. III 313:613–618, 1991.Google Scholar