Initial experience of novel over the wire type decapolar catheter for ventricular arrhythmias originating from left ventricular summit

Solving the Reach Problem: A Review of Present and Future Approaches for Addressing Ventricular Arrhythmias Arising from Deep Substrate

“…Alcohol ablation (AA) has been increasingly used as a bailout to ablation of intramural foci, especially with the increased use of epicardial and CVS activation mapping. [72][73][74] This method may be performed with ethanol delivered through a transarterial or retrograde coronary venous approach. [75][76][77] Limitations of the technique, particularly for transcoronary AA, are collateral injury to the conduction system and larger than intended infarction territory due to chemical reflux through collateral connections.…”

Advanced ventricular arrhythmia ablation: step-by-step problem-solving

“…The study by Miyamoto et al describes early clinical experience with a novel mapping catheter (EPstar FIX AIV, Japan Lifeline, Tokyo, Japan) that is Decapolar (1.3-mm electrodes spaced 5 mm), only 2.7 Fr and has a lumen that can accommodate a 0.014″ guidewire and contrast injection for branch venography to help accomplish safe and effective mapping of the coronary venous space [13]. 5) What if it is not endocardial or epicardial?…”

“…Midmyocardial sites of origin are challenges for even the most experienced operators. Intramural branch mapping of the coronary venous system with lowprofile microelectrode catheters, as discussed above [13], is helpful diagnostically, but therapeutically, deeper penetration is needed. Huang and colleagues present ex vivo data on a novel, "focused electrical field" technology that consists of a geometrically focused tip that attaches onto an existing RF catheter and collimates the beam, achieving 14-mm deep lesions without increase in steam pops [14].…”