Bipolar irrigated radiofrequency ablation: A therapeutic option for refractory intramural atrial and ventricular tachycardia circuits

Koruth, Jacob S.; Dukkipati, Srinivas; Miller, Marc A.; Neužil, Petr; d’Ávila, André; Reddy, Vivek Y.

doi:10.1016/j.hrthm.2012.08.001

Cited by 203 publications

(166 citation statements)

References 26 publications

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“…Merino et al delivered RF energy between two nonirrigated electrodes located in the aortic sinus of the Valsalva and the LV to treat idiopathic VT 16. In the series of nine patients, Koruth et al performed bipolar ablation in four patients with septal and two with LV free wall VT 7. Similar to our findings, they found only a small septal scar without late potentials in this group of patients.…”

Section: Discussionsupporting

confidence: 86%

“…Bipolar ablation is when the RF current flows between two closely located rings 9. Lesions created by bipolar ablation are narrower and deeper, resulting in a transmural scar in the tissue as thick as 25 mm 7. With good control of the impedance and contact pressure, the bipolar source of RF energy seems safe, and this has confirmed by another study 10.…”

Section: Discussionmentioning

confidence: 83%

“…This arrhythmia is always challenging to ablate, as the thickness of the muscle does not allow to achieve transmurality with unipolar approach. Recently, there have been a few reports on bipolar ablation 6, 7 We describe our initial experience with bipolar ablation of septal ventricular arrhythmia.…”

Section: Introductionmentioning

confidence: 99%

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Bipolar irrigated radiofrequency ablation of resistant ventricular tachycardia with a septal intramural origin: the initial experience and a description of the method

Baszko

Telec

Kałmucki

et al. 2016

Clinical Case Reports

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Key Clinical MessageBipolar radiofrequency (RF) ablation is effective in treatment of ventricular tachycardia originating from thick interventricular septum. The RF generator and CARTO system can be used to precisely and safely perform ablation. Standard ablation catheter can be used with indifferent ablation electrode connected to the electrode receptacle in RF generator with custom‐made cable.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 83%

See 1 more Smart Citation

Bipolar irrigated radiofrequency ablation of resistant ventricular tachycardia with a septal intramural origin: the initial experience and a description of the method

Baszko

Telec

Kałmucki

et al. 2016

Clinical Case Reports

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show abstract

“…Bipolar radiofrequency current was applied between two distal ablation catheter electrodes on both sides of the myocardium. A high effectiveness of a bipolar ablation has been reported; however, there are some disadvantages as compared to the SURF ablation 12, 15, 18. When performing a SURF ablation, we can monitor the biophysical parameters of the lesion creation, including the power delivery, local electrode temperature, and impedance profiles on both sides of the myocardium.…”

Section: Discussionmentioning

confidence: 99%

Pathology after a combination of sequential and simultaneous unipolar radiofrequency ablation of ventricular tachycardia in a postmortem heart with cardiac sarcoidosis

Miyamoto

Matsuyama

Noda

et al. 2018

Clinical Case Reports

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Key Clinical MessageThis report shows a postmortem examination of a heart performed in a patient with cardiac sarcoidosis undergoing a sequential and simultaneous unipolar radiofrequency ablation. A combination of a sequential and simultaneous unipolar radiofrequency ablation might be useful for creating transmural ablation lesions on the interventricular septum in patients with cardiac sarcoidosis.

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“…63,64 The technique has also been demonstrated to be effective in case reports and small series of patients with VT which is refractory to conventional ablation techniques. 65,66 An interesting novel technique designed to reach deep intramyocardial arrhythmogenic substrates is needle-based catheter ablation. 67 The catheter design has a needle tip which can be expanded and retracted.…”

Section: A C B Dmentioning

confidence: 99%

New Ablation Technologies and Techniques

Mahida

Berte

Yamashita

et al. 2014

Arrhythmia &Amp; Electrophysiology Review

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Since the first catheter ablation for cardiac arrhythmia more than three decades ago, ablation technology has continually evolved at a rapid pace. Much of the early progress in the field was made in ablation of supraventricular tachycardias. Following a seminal study from Haïssaguerre et al. 1 in 1998, which demonstrated that pulmonary vein triggers are important sources of atrial fibrillation (AF), the approach to management of AF underwent a revolution. Electrical isolation of pulmonary veins (PVs) using catheter ablation became an established therapeutic strategy in patients with paroxysmal AF. During subsequent years, the role of ablation in AF expanded, and more extensive strategies involving ablation of non-pulmonary vein triggers and modification of the left atrial substrate were demonstrated to be effective, even in persistent forms of AF. New Technologies and Techniques for AF AblationCurrently, the most widely used technique for PV isolation involves delivery of point-by-point ablation lesions around the circumference of the vein. A number of different variations to the approach have been developed. During the early stages of PV isolation, a 'segmental approach' which involved targeting the earliest PV potentials at the ostium of the PV was commonly used. Due to high reconnection rates and the risk of PV stenosis, the technique has progressively been modified and the prevailing technique involves circumferential antral ablation to achieve PV isolation. AbstractCatheter ablation is an established treatment strategy for a range of different cardiac arrhythmias. Over the past decade two major areas of expansion have been ablation of atrial fibrillation (AF) and ventricular tachycardia (VT) in the context of structurally abnormal hearts. In parallel with the expanding role of catheter ablation for AF and VT, multiple novel technologies have been developed which aim to increase safety and procedural success. Areas of development include novel catheter designs, novel navigation technologies and higher resolution imaging techniques. The aim of the present review is to provide an overview of novel developments in AF ablation and VT ablation in patients with of structural cardiac diseases.

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Bipolar irrigated radiofrequency ablation: A therapeutic option for refractory intramural atrial and ventricular tachycardia circuits

Cited by 203 publications

References 26 publications

Bipolar irrigated radiofrequency ablation of resistant ventricular tachycardia with a septal intramural origin: the initial experience and a description of the method

Bipolar irrigated radiofrequency ablation of resistant ventricular tachycardia with a septal intramural origin: the initial experience and a description of the method

Pathology after a combination of sequential and simultaneous unipolar radiofrequency ablation of ventricular tachycardia in a postmortem heart with cardiac sarcoidosis

New Ablation Technologies and Techniques

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