Bipolar radiofrequency ablation delivered from coronary veins and adjacent endocardium for treatment of refractory left ventricular summit arrhythmias

An update to an update on radiofrequency bipolar catheter ablation

“…It has been recently shown that Bi-RFCA can overcome some problems of conventional unipolar approach. [2][3][4][5][6][7] We agree with the authors that Bi-RFCA can face some limitations, however some of them can be overpassed. For example, by customizing bipolar cable/adapter, signals from tip and rings of a catheter used as a ground can be transferred to threedimensional (3D) system and this can allow of impedance-based 3D visualization of the catheter used as a ground, as well as to display intracardiac signals on any electrophysiological system.…”

Editorial to “Bipolar radiofrequency catheter ablation between the left ventricular endocardium and great cardiac vein for refractory ventricular premature complexes originating from the left ventricular summit”

“…In contrast, bipolar ablation does not cause dispersion of electromagnetic radiation and it can be expected to ablate deeper lesion in between two electrodes which deliver radiofrequency energy. 1 In the three cases in the report, they probably obtained successful results through this specific mechanism of bipolar ablation. This method is expected to be highly useful in specific cases with intramural lesion.…”

“…In standard unipolar ablation, electromagnetic radiation will be dispersed depending on the distance from the catheter tip, and appropriate aggregation of energy cannot be expected in deeper lesion. In contrast, bipolar ablation does not cause dispersion of electromagnetic radiation and it can be expected to ablate deeper lesion in between two electrodes which deliver radiofrequency energy . In the three cases in the report, they probably obtained successful results through this specific mechanism of bipolar ablation.…”

Bipolar radiofrequency catheter ablation between the left ventricular endocardium and great cardiac vein for refractory ventricular premature complexes originating from the left ventricular summit

“…Bipolar radiofrequency catheter ablation (RFCA) can reportedly create transmural lesions by using 2 ablation catheter tips as active electrodes (AEs) and return electrodes (REs) . Previous reports have shown the effectiveness of bipolar RFCA for VAs originating from the LV summit . There are several bipolar RFCA settings and we have recently reported a case of successful bipolar ablation involving changing an irrigated catheter to an 8‐mm‐tip catheter to reduce the impedance .…”

“…3 Previous reports have shown the effectiveness of bipolar RFCA for VAs originating from the LV summit. 4 There are several bipolar RFCA settings and we have recently reported a case of successful bipolar ablation involving changing an irrigated catheter to an 8-mm-tip catheter to reduce the impedance. 5 However, the effectiveness and safety of bipolar RFCA from the coronary venous system for VAs originating from the LV summit and the appropriate settings of bipolar RFCA remain unclear.…”