Introduction: Irreversible electroporation (IRE) is a promising technique for the focal treatment of soft tissue tumors. Even though the local application of an excessive electric field is a potential cause of cardiac arrhythmias, initial clinical studies have shown that IRE is generally safe when cardiac gating is employed.
Case description: In this case report, we observed an episode of ventricular extrasystoles without hemodynamic changes during which time the synchronization device failed to operate properly, with pulses delivered not in the absolute refractory period but in the relative refractory period.
Discussion and evaluation: At present, persons performing IRE must keep in mind that there is a small but real risk of synchronization failure even when a cardiac synchronization device is used.
Conclusion: It is advisable to err on the side of caution when treating lesions near the heart.
Keywords: Arrhythmia; Complication; Irreversible electroporation; Liver; Metastasis; Tumor.