Healing the Heart with Electricity

A research team from the Hebrew University of Jerusalem, led by Professor Boris Rubinsky, has developed a technique for eliminating recurring blockage of arteries following a heart attack by using short electric pulses. This invention could save the lives of millions of cardiac patients worldwide.
 Seen at right is a full and partial view of an artery that has been treated with IRE. At left is an untreated artery. (Credit: Prof. Boris Rubinsky)
Seen at right is a full and partial view of
an artery that has been treated with IRE.
At left is an untreated artery.
(Credit: Prof. Boris Rubinsky)

Angioplasty is the common treatment for acute myocardial infraction (heart attack). A heart attack is a condition resulting from abrupt interruption in blood supply to a part of the beating heart, usually due to a plaque-rupture in an atherosclerotic coronary artery. Atherosclerosis is the process of progressive thickening and hardening of the artery walls due to the fat deposits on their inner lining. Atherosclerotic heart disease is the leading cause of death in the US.

In the process of angioplasty, a cardiologist inserts a balloon into the blocked artery and inflates it at the point of blockage, thus dilating the artery and allowing blood to pass through. This procedure is usually followed by stent implantation which is meant to protect the artery and prevent restenosis (recurring blockage of the blood vessel). However, the existing procedure is known to cause damage to the arterial wall. The epithelial cells react to the damage by excessive growth of scar tissue which causes a different type of recurrent blockage. Therefore, restenosis remains a major clinical problem in cardiology.

The Hebrew University research team led by Professor Rubinsky sought to solve the problem of scar tissue restenosis by employing the biophysical phenomenon of Irreversible Electroporation (IRE). IRE can be applied to destroy cells within seconds by using very short electric field pulses. This technique does not cause damage to any structures but the cells. Furthermore, IRE is very easy to deploy and does not require any special training of the medical staff.

 Prof. Boris Rubinsky (Credit: The Hebrew University)
Prof. Boris Rubinsky
(Credit: The Hebrew University)

During IRE, electrical fields are applied across targeted cells and penetrate the cell membranes. The electrical fields cause permanent damage to the cell membranes which leads to decreased loss of cell stability and cell death. The damage is limited to cell membranes only and does not affect any other structures in the surrounding area. The team showed that IRE is capable of destroying the cells damaged during angioplasty which are responsible for restenosis in rats. In the study, IRE destroyed the cells within 23 seconds causing no damage to any surrounding tissue.

Before the technique can be used in hospitals as a treatment for the general public, it needs to undergo extensive clinical trials in humans. As a means of destroying only specific cells, IRE has recently become widely researched as a possible tool to fight cancer. In fact, the technique has been recently used for the first time on human subjects for the treatment of prostate, liver, and lung tumors.

TFOT has recently brought you the story of a new medication which can reduce the chance of a recurring artery block after stent implantation, developed by the Israeli Company BIOrest. We have also covered the development of stem cells that can rebuild heart tissue in a research conducted at the University of Washington.

For more information on the new IRE technique, please visit Hebrew University’s news page.

Image icon credit: Patrick J. Lynch