Guidewire ablation of epicardial ventricular arrhythmia within the coronary venous system: A case report

Xuan, Fengqi; Liang, Ming; Li, Sainan; Zuo, Zhongyin; Han, Yaling; Wang, Zulu

doi:10.1016/j.hrcr.2021.12.011

Cited by 6 publications

(9 citation statements)

References 13 publications

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“…These studies initially confirmed the feasibility of intravenous GA in the treatment of IVAs. Then, our center has upgraded the GA device and used BMW UNIVERSAL II GUIDEWIRE for mapping and ablation in the CVS 14 . During the procedure, the guidewire is threaded into the Cosair microcatheter for mapping and ablation.…”

Section: Discussionmentioning

confidence: 99%

“…Then, our center has upgraded the GA device and used BMW UNIVERSAL II GUIDEWIRE for mapping and ablation in the CVS. 14 During the procedure, the guidewire is into the Cosair microcatheter for mapping and ablation. The tip of guidewire is then adjusted to be exposed for 5 mm to ensure accurate mapping and exposed for 25 mm for ablation.…”

Section: Ga For Ivamentioning

confidence: 99%

“…[9][10][11][12][13] We have reported a case of premature ventricular contraction (PVC) successfully ablated in the distal GCV by a modified percutaneous transluminal coronary intervention guidewire. 14 Nevertheless, as a novel technique, the biophysical characteristics of guidewire ablation (GA) have not been fully clarified. In this study, we aim to investigate the influences of vessel diameters, ablation power, and duration on lesion radius of GA through in vitro and in vivo experiments.…”

Section: Introductionmentioning

confidence: 99%

“…In the past decades, there have been some reports about the application of guidewire for mapping and ablating ventricular arrhythmias 9–13 . We have reported a case of premature ventricular contraction (PVC) successfully ablated in the distal GCV by a modified percutaneous transluminal coronary intervention guidewire 14 . Nevertheless, as a novel technique, the biophysical characteristics of guidewire ablation (GA) have not been fully clarified.…”

Section: Introductionmentioning

confidence: 99%

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Effects of parameters on radiofrequency guidewire ablation: In vitro and in vivo experiments

Zuo,

Li,

Xuan

et al. 2023

Cardiovasc electrophysiol

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BackgroundA novel ablation technique with guidewire has emerged as a promising approach for mapping and ablation of arrhythmias originating from left ventricular summit. However, its biophysical characteristics have not been fully clarified.Methods and ResultsIn the in vitro experiment, guidewire ablation (GA) was performed in vessel models of 1.17 and 2.24 mm to determine the maximum safety power. Then with the maximum safety power, the predictive value of generator impedance (GI) drop on lesion radius was explored. In the in vivo experiment, the feasibility of the maximum safety power and lesion formation was verified in the living swine. It was found that in both groups, the incidence of steam pops increased along with the raise of ablation power, and the maximum safety power was 10 W for the 1.17‐mm group and 15 W for the 2.24‐mm group. There was a strong linear correlation between GI drop and maximum lesion radius (in 1.17 mm‐10‐W group: r = .961; in 2.24 mm‐15‐W group: r = .918). In the in vivo experiment, besides ventricular fibrillation happened once, no other complications were observed, and lesions were found at both 48‐h and 8‐week groups.ConclusionsThe safety power of GA should be adjusted according to the diameter of the vessel. Besides, the GI drop can predict the lesion radius during GA.

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Section: Discussionmentioning

confidence: 99%

Section: Ga For Ivamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of parameters on radiofrequency guidewire ablation: In vitro and in vivo experiments

Zuo,

Li,

Xuan

et al. 2023

Cardiovasc electrophysiol

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“…reported two successful cases in which the guidewire was advanced into the epicardial interest site through the distal GCV/AIV for LVS‐VAs mapping and ablation. The power used ranged from 10 to 20 W, with the energy delivery lasting for 20 to 30 s. Similarly, Xua et al 40 . also reported a case of LVS VAs ablated in CVS using a guidewire.…”

Section: Guidewire Ablation Via Cvsmentioning

confidence: 98%

Mapping and ablation of ventricular arrhythmias arising from the left ventricular summit

Zhou,

Zheng,

et al. 2024

Pacing Clinical Electrophis

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The left ventricular summit (LVS) refers to the highest portion of the left ventricular outflow tract (LVOT). It is an epicardially delimited triangular area by the left coronary arteries and the coronary venous circulation. Its deep myocardium correlates closely with the left coronary cusp, aortic‐mitral continuity, and right ventricular outflow tract (RVOT), complicating the anatomical relationship. Ventricular arrhythmias (VAs) originating from this area are common, accounting for 14.5% of all VAs origin from left ventricle. Specific electrocardiogram (ECG) characteristics may assist in locating LVS‐VAs pre‐procedure and facilitate procedure planning. However, catheter ablation of LVS‐VAs remains challenging because of anatomical constraints. This paper reviews the recent understanding of LVS anatomy, concludes ECG characteristics, and summarizes current mapping and ablation methods for LVS‐VAs.

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Exploring the Full Potential of Radiofrequency Technology: A Practical Guide to Advanced Radiofrequency Ablation for Complex Ventricular Arrhythmias

Tonko,

Lambiase

2024

Curr Cardiol Rep

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Purpose of Review Percutaneous radiofrequency (RF) catheter ablation is an established strategy to prevent ventricular tachycardia (VT) recurrence and ICD shocks. Yet delivery of durable lesion sets by means of traditional unipolar radiofrequency ablation remains challenging, and left ventricular transmurality is rarely achieved. Failure to ablate and eliminate functionally relevant areas is particularly common in deep intramyocardial substrates, e.g. septal VT and cardiomyopathies. Here, we aim to give a practical-orientated overview of advanced and emerging RF ablation technologies to target these complex VT substrates. We summarize recent evidence in support of these technologies and share experiences from a tertiary VT centre to highlight important “hands-on” considerations for operators new to advanced RF ablation strategies. Recent Findings A number of innovative and modified radiofrequency ablation approaches have been proposed to increase energy delivery to the myocardium and maximize RF lesion dimensions and depth. These include measures of impedance modulation, combinations of simultaneous unipolar ablations or true bipolar ablation, intramyocardial RF delivery via wires or extendable RF needles and investigational linear or spherical catheter designs. Recent new clinical evidence for the efficacy and safety of these investigational technologies and strategies merits a re-evaluation of their role and clinic application for percutaneous VT ablations. Summary Complexity of substrates targeted with percutaneous VT ablation is increasing and requires detailed preprocedural imaging to characterize the substrate to inform the procedural approach and selection of ablation technology. Depending on local experience, options for additional and/or complementary interventional treatments should be considered upfront in challenging substrates to improve the success rates of index procedures. Advanced RF technologies available for clinical VT ablations include impedance modulation via hypotonic irrigation or additional dispersive patches and simultaneous unipolar as well as true bipolar ablation. Promising investigational RF technologies involve an extendable needle RF catheter, intramyocardial RF delivery over intentionally perforated wires as well as a variety of innovative ablation catheter designs including multipolar linear, spherical and partially insulated ablation catheters.

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Guidewire ablation of epicardial ventricular arrhythmia within the coronary venous system: A case report

Cited by 6 publications

References 13 publications

Effects of parameters on radiofrequency guidewire ablation: In vitro and in vivo experiments

Effects of parameters on radiofrequency guidewire ablation: In vitro and in vivo experiments

Mapping and ablation of ventricular arrhythmias arising from the left ventricular summit

Exploring the Full Potential of Radiofrequency Technology: A Practical Guide to Advanced Radiofrequency Ablation for Complex Ventricular Arrhythmias

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