3 The procedure
3.1 The aim of irreversible electroporation is to destroy cancerous cells by subjecting them to a series of short electrical pulses using high-voltage direct current. This creates multiple holes in the cell membrane, irreversibly damaging the cell's homeostatic mechanisms and leading to cell death.
3.2 The procedure is done with the patient under general anaesthesia. A neuromuscular blocking agent is essential to prevent uncontrolled severe muscle contractions caused by the electric current. A number of electrode needles (typically 3 to 5) are introduced percutaneously and inserted into, and adjacent to, the tumour using image guidance. A series of very short electrical pulses is delivered over several minutes to ablate the tumour. The electrodes may be repositioned to extend the zone of electroporation until the entire tumour and an appropriate margin have been ablated.
3.3 Cardiac synchronisation is used to time delivery of the electrical pulse within the refractory period of the heart cycle, minimising the risk of arrhythmia.