and safety at 30 days. Multicentre, randomised studies comparing PFA with other ablation energy sources are necessary to confirm the favourable findings observed in this study.. Conclusions: RF ablation catheters remain the dominant technology, representing nearly 80% of total revenues. PFA is one of the newest technologies for ablation and aims to reduce procedure complications associated with current approaches. 10 Sessions, 26 Papers, 16 Presentations. Pulsed-field ablation (PFA) is an emerging nonthermal ablation technology. Pulsed Field Ablation Treats AF With Few Complications Daniel M. Keller, PhD April 14, 2022 In an unselected population of patients with paroxysmal or persistent atrial fibrillation (AF), the. In this non-randomised, prospective, multicentre, premarket clinical study, the research team recruited 38 patients (aged 1880) who were diagnosed with paroxysmal or persistent atrial fibrillation (AF). How does the level of pulmonary venous isolation compare between pulsed field ablation and thermal energy ablation (radiofrequency, cryo, or laser)? Results: In 121 patients, acute PVI was achieved in 100% of PVs with PFA alone. 2 Meckes D, Emami M, Fong I, Lau DH, Sanders P, PULSED-FIELD ABLATION: COMPUTATIONAL MODELLING OF ELECTRIC FIELDS FOR LESION DEPTH ANALYSIS, Heart Rhythm O2. The author illustrates that the research team achieved acute electrical isolation in 100% of the pulmonary veins (n=152) across the 38 patients. APAC: +91 40 6616 6809, Pulsed field ablation tech gaining popularity in the cardiovascular electrophysiology market, says GlobalData, GlobalData Plc 2022 | Registered Office: John Carpenter House, John Carpenter Street, London, EC4Y 0AN, UK | Registered in England No. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Write to us Isolation is achieved via the application of high-voltage microsecond pulses that create irreversible perforations in cell membranes (i.e., electroporation). At one year, this translated to low rates of AF and other atrial arrhythmia recurrence. RBC was contacted to design and develop an RFIRE electroporation system to be used in pre-clinical investigation of therapeutic soft tissue destruction. Online ahead of print. Reddy VY, Neuzil P, Koruth JS, Petru J, Funosako M, Cochet H, Sediva L, Chovanec M, Dukkipati SR, Jais P. J Am Coll Cardiol. Success rates for current ablation procedures vary between 60% and 75%. This is why many pain doctors prefer pulsed radiofrequency. These data help allay concern that the novel non-thermal ablative mechanism of this energy modality masks undiscovered compromises to clinical success, they write. After a 90-day blanking period, arrhythmia recurrence was assessed over 1-year follow-up. Vivek Reddy discloses that he is a consultant on behalf of and owns stock in Farapulse. More recent preclinical data with newer biphasic PFA waveforms have encouragingly been shown to create contiguous, homogenous, transmural atrial lesions and to achieve relevant endpoints such as durable PV isolation.19 Importantly, each PFA waveform should be considered a unique entity and requires detailed preclinical safety and efficacy assessment. PFA is a strikingly promising and novel non-thermal ablative strategy that has the capability to overcome certain limitations of contemporary AF ablation technologies. Herein, iron-based nanoparticles (FeNPs), metallic nanoparticles, were synthesized via a facile chemical . In ventricular tissue, PFA has been shown to create large lesions with sparing of the vasculature and nerves within and adjacent to the lesion.15 Additionally, PFA has been shown to spare the esophageal mucosal and sub-mucosal layers despite deliberate application of PFA on the esophagus.16,17 PFA has also been shown to not injure the phrenic nerve despite multiple applications along its course.18 These important findings suggest that PFA has a unique safety profile that makes it extremely attractive for atrial tissue ablation. Bethesda, MD 20894, Web Policies In addition, catheter ablation can be associated with other complications such as PV stenosis, steam pops, and the risk of embolic strokes.4,5 These safety limitations are unfortunately compounded by the lack of consistent lesion transmurality, a known mechanism for AF recurrence.6 Thus, there has been a pressing need for an ablative strategy that is not only very efficacious but also extremely safe. This must be kept in mind as newer PFA technologies make their way into the clinical realm. 2022 Oct 15. doi: 10.1007/s10840-022-01398-4. Aims: Pulsed-field ablation (PFA) is an emerging non-thermal ablation method based on the biophysical phenomenon of electroporation. Invasive remapping was performed at 2 to 3 months, and reconnected PVs were reisolated with PFA or radiofrequency ablation. The author also noted that before the procedure, a full baseline evaluation was carried out on all patients. AF Symposium 2022: Lower pulmonary vein to left atrium volume ratio predicts AF recurrence, Telehealth accessible for diverse paediatric electrophysiology patient population, Same-day discharge for catheter ablation of atrial fibrillation deemed safe and feasible. I believe that PFA represents a sea change in how we deliver ablation energy. 2021 Jun;18(6):878-884. doi: 10.1016/j.hrthm.2021.02.020. Currently available energy modalities such as radiofrequency, cryotherapy, and laser-based PV isolation (PVI) are limited by long-term PV reconnection rates that, at best, range from 22% to 38%,1,2 with other studies reporting rates as high as 62.5%.3 Tissue heating (radiofrequency) or freezing (cryotherapy), the two most commonly used approaches, ablate tissue in an indiscriminate manner without distinguishing tissue planes. It causes debilitating and life limiting symptoms such as palpitations, breathlessness and fatigue. It's supposed to take far less time and is more accurate in finding and eliminating aberrant cells and has a better success rate. United States: Furthermore, PV remapping performed in 110 patients at 93.030.1 days, demonstrated durable PVI in 84.8% of PVs (64.5% of patients), and 96% of PVs (84.1% of patients) treated with the optimised biphasic energy PFA waveform. Dr. Koruth has served as a consultant for Farapulse, Medtronic, Vytronus, Abbott, and Cardiofocus; and has received grant support from Farapulse, Vytronus, Cardiofocus, Luxcath, Affera, LuxCath, and Medlumics. which was performed to ensure a left ventricular ejection fraction of 35% and no gross enlargement of the left atrium >5cm. Pulsed field ablation for pulmonary vein isolation: real-world experience and characterization of the antral lesion size compared with cryoballoon ablation. Energy is delivered through all of the electrodes in a proprietary sequence. The diameter of the catheter is measured in the fully deployed flower configuration. Preclinical experimental feasibility data on PFA as an ablative therapy for myocardial tissue have been accruing over the last decade.4,10-14 PFA lesions in cardiac tissue are characteristically homogeneous and spare the extracellular matrix within the tissue scaffolding.4 This contrasts with indiscriminate and disruptive lesions created with thermal energy sources. The author also noted that before the procedure, a full baseline evaluation was carried out on all patients. These patients, the author notes, were treated in six centres across Australia (n=5), Canada (n=7), USA (n=22), and The Netherlands (n=4), with the primary outcome to achieve acute PVI intraprocedurally. As PFA is a novel form of ablation which uses electrical fields to ablate cardiac tissue, the authors note that there is currently limited data on assessing the safety of this ablation method in humans. A recent study has demonstrated 100% pulmonary vein isolation (PVI) using only pulsed field ablation (PFA), resulting in no PFA-related serious adverse events. Although the tech is still largely in a developmental stage, early clinical results have been promising, demonstrating its efficacy in the treatment of atrial fibrillation.. Front Cardiovasc Med. This editorial refers to 'Pulsed field ablation prevents chronic atrial fibrotic changes and restrictive mechanics after catheter ablation for atrial fibrillation' by Y. Nakatani et al., pages 1767--1776. The safety and efficacy of pulsed field ablation (PFA) in Patients with Paroxysmal Atrial Fibrillation (PAF) will be studied using ring-shaped pulsed field ablation catheter. eCollection 2022. Pulsed field ablation (PFA) is rapidly emerging as a novel energy source. 2022.. 3 All members of the Clinical . Pulsed field ablation (PFA) is a novel method of pulmonary venous isolation in atrial fibrillation ablation and is featured by tissue-selective ablation. It will likely take over from thermal energies for AF ablation, making these procedures safer and faster for patients, Verma told Cardiac Rhythm News. Conversely, biphasic PFA waveforms have demonstrated limited skeletal muscle engagement, allowing it to be used clinically without the need for paralytics.9. Lemoine MD, Fink T, Mencke C, Schleberger R, My I, Obergassel J, Bergau L, Sciacca V, Rottner L, Moser J, Kany S, Moser F, Mnkler P, Dinshaw L, Kirchhof P, Reissmann B, Ouyang F, Sommer P, Sohns C, Rillig A, Metzner A. Clin Res Cardiol. Inc) set to 30 W with saline flow rate of 17 mL/min . The estimated freedom from arrhythmia at 12 months in this study was 87 5.6%. Limited by Federal (or United States) law to investigational use in the United States. JPM 2022: Dexcom, Edwards, J&J, Medtronic, ResMed The annual J.P. Morgan Healthcare Conference includes presentations from major medtech companies describing their experience in 2021 and expectations for 2022 as . Study shares success of complete PVI using only pulsed field ablation 25th January 2022 5516 Atul Verma A recent study has demonstrated 100% pulmonary vein isolation (PVI) using only pulsed field ablation (PFA), resulting in no PFA-related serious adverse events. Until now, catheter ablations to treat AF have mostly used thermal energy, by either burning or freezing problematic heart tissue. Smaller manufacturers are also racing to develop PFA devices to gain share in cardiac electrophysiology device markets. Ablative energy is delivered from all electrodes. 2 - Reddy VY, Dukkipati SR, Neuzil P, et al. The catheter shape is changed through the manipulation of a slider mechanism on the handle of the catheter. Email: [emailprotected] PV remapping, performed in 110 patients at 93.0 30.1 days, demonstrated durable PVI in 84.8% of PVs (64.5% of patients), and 96.0% of PVs (84.1% of patients) treated with the optimized biphasic energy PFA waveform. Front Matter: Volume 10911 (1) LASE Plenary Session (1) Surface Treatment I (5) Surface Treatment II (4) Laser Cladding (1) Process Monitoring and Control (5) Cutting and Drilling (4) Beam Manipulation, Transport, Measurement and Simulation (2) Loh et al. MeSH Regarding PFA and atrial tissue, investigators have demonstrated completely ablated myocardial sleeve with 200 Joule monophasic applications in porcine PV ostia without significant scarring or proliferation of the intima and the elastic lamina.11 Importantly, despite creating lesions within the PV itself, the PV diameters were not affected,10,11 attesting to PFAs unique non-stenotic ablative mechanism. In a sub-analysis of patients with very LSR, comparable rates of device success and safety outcomes were observed, while mortality at 1 to 3 years was lower. Acute PVI was safely achieved in 100% (40 PV) patients with a minimum of 2 non-arcing 6 ms, 200 Joule applications per PV using a monopolar monophasic waveform.22 The safety and PVI durability outcomes of this series have not yet been reported. official website and that any information you provide is encrypted Opportunities for new therapies will be presented. Fletcher concludes:It is not immediately clear how the arrival of PFA devices will shape the cardiovascular electrophysiology market over the coming years. The longterm success rate in arrhythmia treatment is reported to be 50%-64% for patients receiving a single RF ablation treatment, . Part of the Farapulse pulsed-field ablation system, the Farawave single-shot catheter is designed to create durable and circumferential lesions. Pulsed field ablation (PFA) is a nonthermal energy modality that has been utilized for both gene electrotransfer and solid organ tumor ablation for many years. TEL: +1 949 723 9309 Pulsed electric field is a novel energy source by which high-voltage electric pulses are used to create irreversible electroporation that could potentially break the trade-off between effective lesions and collateral damage and substantially improve risk-benefit ratios in atrial fibrillation (AF) ablation. Kawamura I, Neuzil P, Shivamurthy P, Kuroki K, Lam J, Musikantow D, Chu E, Turagam MK, Minami K, Funasako M, Petru J, Choudry S, Miller MA, Langan MN, Whang W, Dukkipati SR, Koruth JS, Reddy VY. Reddy VY, Anter E, Rackauskas G, Peichl P, Koruth JS, Petru J, Funasako M, Minami K, Natale A, Jais P, Nakagawa H, Marinskis G, Aidietis A, Kautzner J, Neuzil P. Circ Arrhythm Electrophysiol. In 3 multicenter studies (IMPULSE [A Safety and Feasibility Study of the IOWA Approach Endocardial Ablation System to Treat Atrial Fibrillation], PEFCAT [A Safety and Feasibility Study of the FARAPULSE Endocardial Ablation System to Treat Paroxysmal Atrial Fibrillation], and PEFCAT II [Expanded Safety and Feasibility Study of the FARAPULSE Endocardial Multi Ablation System to Treat Paroxysmal Atrial Fibrillation]), paroxysmal atrial fibrillation patients underwent PVI using a basket or flower PFA catheter. Adv Chen S, Schmidt B, Bordignon S, Tohoku S, Urbanek L, Schaack D, Chun JKR. You have entered an incorrect email address! Pulsed Field Ablation (A) The ablation catheter is delivered over the wire and contains 5 splines, each containing 4 electrodes. Three-month PVI durability progressively increased from 18% with the initial monophasic waveform to 100% with the more optimized bipolar waveforms in the last cohort in this study. Pulsed field ablation prevents chronic atrial fibrotic changes and restrictive mechanics after catheter ablation for atrial fibrillation. We demonstrate that ablation with nanosecond pulsed electric fields (nsPEFs) can potentially overcome these limitations. Interest in PFA technology has been shared by both large and small manufacturers in the cardiac electrophysiology device market. Clinical investigations evaluating devices from Medtronic, Acutus Medical, Farapulse, and Biosense Webster are currently underway in the US and Europe. In summary, PFA is capable of rapidly isolating PV with an excellent short-term safety profile and long-term durability. BIBA Medical, Europe526 Fulham Road, Fulham, London, SW6 5NR All rights reserved. When adequately dosed/configured it shows a preference for myocardial tissue necrosis. Microporation of tissue for delivery of bioactive agentsMicroporation of tissue for delivery of bioactive agents . . . Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism, ACC Anywhere The ACC.22 Meeting on Demand Program, CardioSource Plus for Institutions and Practices, Annual Scientific Session and Related Events, ACC Quality Improvement for Institutions Program, National Cardiovascular Data Registry (NCDR), Left Ventricular Activation Time Shortening With Conduction System Pacing vs Biventricular Resynchronization Therapy, Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation, Dapagliflozin and Cause-Specific Mortality in HF Across Spectrum of EF, CMMI Releases One-Year Report on Strategy to Support Patient-Centered Value-Based Specialty Care, A Deep Patient-Similarity Learning Framework For Age-Invariant Recognition of Diastolic Dysfunction in Elderly Patients, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism. Funding Support and Author Disclosures This study was funded by a research grant from Farapulse Inc. Dr. Reddy has served as a consultant for Farapulse, Biosense Webster, Abbott, Ablacon, Acutus Medical, Affera, Apama Medical, Aquaheart, Atacor, Autonomix, Axon Therapeutics, Backbeat, BioSig, Biotronik, Boston Scientific, Cardiac Implants, CardiaCare, Cardiofocus, Cardionomic, CardioNXT/AFTx, Circa Scientific, Corvia Medical, Dinova-Hangzhou Nuomao Medtech, East End Medical, EBR, EPD, Epix Therapeutics, EpiEP, Eximo Fire1, HRT, Impulse Dynamics, Intershunt, Javelin, Kardium, Keystone Heart, LuxMed, Medlumics, Medtronic, Middlepeak, Nuvera, Philips, Pulse Biosciences, Sirona Medical, Thermedical, and Valcare; owns equity in Ablacon, Acutus Medical, Affera, Apama Medical, Aquaheart, Atacor, Autonomix, Axon Therapeutics, Backbeat, BioSig, Cardiac Implants, CardiaCare, Circa Scientific, Corvia Medical, Dinova-Hangzhou Nuomao Medtech, East End Medical, EPD, Epix Therapeutics, EpiEP, Eximo, HRT, Intershunt, Javelin, Kardium, Keystone Heart, LuxMed, Manual Surgical Sciences, Medlumics, Middlepeak, Newpace, Nuvera, Sirona Medical, Surecor, Valcare, and Vizaramed; and owns stock in Farapulse. Results 41 Patients, median age 69 (interquartile range 62-73) years, 24% female, 56% persistent AF, underwent first PVI by PFA. Lattice-Tip Focal Ablation Catheter That Toggles Between Radiofrequency and Pulsed Field Energy to Treat Atrial Fibrillation: A First-in-Human Trial. (B) The catheter can also be deployed in a ower petal conguration. INDICATIONS FOR USE The FARAPULSE Pulsed Field Ablation (PFA) System is indicated for the isolation of pulmonary veins in the treatment of paroxysmal atrial fibrillation. As a result, the research team set out to evaluate the feasibility and efficacy of PVI using a novel PFA system delivering bipolar, biphasic electrical fields through a circular multielectrode array, non-randomised, prospective, multicentre, premarket clinical study, the research team recruited 38 patients (aged 18, 80) who were diagnosed with paroxysmal or persistent atrial fibrillation (AF). Atrial fibrillation (AF) is the most common heart rhythm disturbance, affecting around 1.4 million people in the UK. BIBA Medical, North America 03925319, In vitro diagnostics expands reach to meet pent-up demand for other diseases and better position manufacturers for market volatilities, says GlobalData, NeuroPaces RNS system may prove to be an essential option to treating idiopathic generalised epilepsy at the source, says GlobalData, Singapore to focus on preventive healthcare through Healthier SG, says GlobalData. As PFA is a novel form of ablation which uses electrical fields to ablate cardiac tissue, the authors note that there is currently limited data on assessing the safety of this ablation method in humans. The 1-year Kaplan-Meier estimates for freedom from any atrial arrhythmia for the entire cohort and for the optimized biphasic energy PFA waveform cohort were 78.5 3.8% and 84.5 5.4%, respectively. In part 1 of the interview, the medtech veteran talked about the company's plan to compete in the crowded pulsed field ablation field. JACC Clin Electrophysiol. Monophasic waveforms typically cause significant muscular activation, mandating the use of general anesthesia and neuromuscular paralysis. Given that we are in the midst of the full-scale emergence of Pulsed Field Ablation (PFA) within the world of clinical cardiac electrophysiology, it's imperative that PFA's place within the. Pulsed field ablation as first-line "efficient" rhythm control for atrial fibrillation complicated with heart failure: proof-of-concept. DOI: 10.1097/HCO.0000000000000810 Abstract Purpose of review: Pulsed field ablation is a nonthermal ablative modality that uses short living, strong electrical field created around catheter to create microscopic pores in cell membranes (electroporation). 8600 Rockville Pike 2022 Aug 16;9:1003843. doi: 10.3389/fcvm.2022.1003843. GlobalData currently values the Electrophysiology Ablation Catheters market at $3.5 billion worldwide, and forecasts that it will reach $4.5 billion by 2030 at a compound annual growth rate (CAGR) of 3.4%. PFA can be delivered in seconds or minutes compared with hours for radiofrequency. EMEA: +44 207 832 4399 Pulsed Field Ablation of Paroxysmal Atrial Fibrillation: 1-Year Outcomes of IMPULSE, PEFCAT, and PEFCAT II. An official website of the United States government. The pulsed-field strength remains independent of tissue contact; therefore, PFA is assumed to be an ablation technology, not mandating the need for tissue contact. If you are a member of the press or media and require any further In this study, the ablation threshold in a cell suspension model was at least 1000 V/cm with 50 pulses of 100 s duration for both neuronal-like cells and cardiomyocytes, and slightly higher for cardiac fibroblasts. Participation eligibility Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Editorial: Insights in cardiac rhythmology 2021. According to the author, Atul Verma (University of Toronto, Southlake Regional Health Centre, Ontario, Canada), the study is the first-in-human clinical trial that focuses on PFA. The latter is a non-thermal ablation method in which high . Keywords: Det fr cellemembranerne til at danne porer, som gr cellerne uttte. 2022 Sep 22. doi: 10.1007/s00392-022-02091-2. Seven-day Holter ECGs were performed at 3 and 6 months after ablation. doi: 10.1161/CIRCEP.120.008718. TEL: +44 (0)20 7736 8788 2020 Jun;13(6):e008718. Jacob Fletcher, Medical Analyst at GlobalData, comments:What differentiates PFA from existing catheter ablation technologies is that it is nonthermal in nature and is more selective towards cardiac tissue. Current ablation technologies suffer from substantial recurrence rates, thermal side effects, and long procedure times. PV remapping, performed in 110 patients at 93.0 30.1 days, demonstrated durable PVI in 84.8% of PVs (64.5% of patients), and 96.0% of PVs (84.1% of patients) treated with the optimized biphasic energy PFA waveform. The current work is thus structured on the knowledge gaps in the LBSM research field to investigate the effects of innovative LO-OLPA on PFLP responses with the aid of recently introduced MRWO. Before Dr. Neuzil has received grant support from Farapulse. 2021 May;7(5):628-629. doi: 10.1016/j.jacep.2021.03.007. The presenter will offer his thoughts on where the field may be headed in the next 5-10 years. Almost one in 200 patients die early after AF ablation in Adagio Medical announces patient enrolment in PARALELL trial, Two decades of development in AF treatment and education, New data underpin drive towards earlier AF ablation strategies, Q-FFICIENCY trial shows promise for temperature-controlled ablation. Bookshelf In this study, the ablation threshold in a cell suspension model was at least 1000 V/cm with 50 pulses of 100 s duration for both neuronal-like cells and cardiomyocytes, and slightly higher for cardiac fibroblasts. 7,8 More recently, investigators have demonstrated a unique safety profile and ablative efficacy related to its ability to selectively target cardiomyocytes while sparing collateral tissue. PFA treatment for acute isolation of PV using circular PV ablation catheter to deliver pulsed electric fields to produce myocardial infraction, has a success rate of 92.0%. Welcome any comments and/or testimonies. Radiofrequency ablation, or RFA, is a process that uses heat to stop the pain in the joint. Electrosurgical generator US10639098; This invention relates to high-frequency 2020 Sep 1;76(9):1068-1080. doi: 10.1016/j.jacc.2020.07.007. information, please get in touch, as we're very happy to help. BIBA Medical, Europe526 Fulham Road, Fulham, London, SW6 5NR Online ahead of print. The PFA system consists of a generator (Farastar, Farapulse) that delivers high-voltage, high-frequency pulses over multiple channels; an over-the-wire 12-F multielectrode PFA catheter (Farawave, Farapulse); a 12-F steerable focal PFA catheter (Faraflex, Farapulse); and a 13-F steerable sheath (Faradrive, Farapulse). Although this is very promising, larger studies with longer follow-up are needed. 155 North Wacker Drive, Suite 4250, Chicago, IL 60606 PDF Pulsed field ablation" government site. Published by Elsevier Inc. All rights reserved. From start-ups to market leaders, access critical company intelligence on a global scale, From industry deep dives to global trends, access authoritative research from our experts, Uncover your next opportunity with trusted data & insights that cut across industries, Access our Webinars, Podcasts, Videos, Free Reports, Discover the disruptive forces shaping tomorrow's world, today, Explore our diverse collection of unique datasets and find the advantage you need, Get clarity into the latest emerging themes with our reports. Experience what our solutions have to offer with free access to highlights of our data, insights and analysis. were the first to describe the initial acute clinical experience with both endocardial and epicardial PFA. The term reversible electroporation refers to non-permanent pore formation when a low-intensity electric field that does not exceed the target tissue's threshold is applied. Med Pulsed field ablation (PFA) laver man kortvarigt et kraftigt hjspndingsfelt omkring det omrde, man nsker at beskadige. RBC also developed requirements for first generation commercialization. 2022 American College of Cardiology Foundation. It is commonly believed that the catheter-tissue contact is nonessential in PFA, considering this technology's nonthermal nature. Keywords: Atrial Fibrillation, Cardiac Tamponade, Feasibility Studies, Follow-Up Studies, Stroke Volume, Catheter Ablation, Anti-Arrhythmia Agents, Endoscopy, Electroporation, Magnetic Resonance Imaging, Cohort Studies, Phrenic Nerve, Myocytes, Cardiac, Pulmonary Veins, Cicatrix, Microscopy, Electron, Scanning, Feasibility Studies, Prospective Studies, Tissue Scaffolds, Catheter Ablation, Constriction, Pathologic, Heart Atria, Heart Rate, Esophageal Fistula, Cryotherapy, Cardiac Surgical Procedures, Endocardium, Electroporation, Cell Membrane, Electrodes, Extracellular Matrix, Cell Death, Muscle, Skeletal, Liver, Anesthesia, General, Cell Proliferation, Stroke, Membrane Lipids, Neoplasms.
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