Multipolar Ablation Using Mapping Electrodes

Fernandes, Gilson; Nguyen, Tri Q.; Creed, Ekaterina; Lee, Kichang; Jung, Kitae; Hack, Benjamin; Hucker, William J.; Hanley, Alan

doi:10.1016/j.jacep.2022.10.029

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…In one of our cases, multipolar ablation was performed by incorporating 2 electrodes of a mapping catheter in the circuit, a strategy that has been recently reported. 17 This novel approach could be considered only in exceptional cases when the ablation catheter cannot be advanced to the area of interest, but caution should be exercised considering this catheter is not intended for ablation. In this case, the dispersive patch still should be included in the circuit as a means to lower the impedance and minimize the risk of steam pops.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bipolar ablation involving coronary venous system for refractory left ventricular summit arrhythmias

Enriquez,

Hanson,

Nazer

et al. 2024

Heart Rhythm O2

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Section: Discussionmentioning

confidence: 99%

“…In 1 case, the second ablation catheter could not be advanced to the site of earliest activation in the GCV, and a multipolar mapping catheter (EPstar, Baylis) was used instead as return electrode. 17 …”

Section: Methodsmentioning

confidence: 99%

Bipolar ablation involving coronary venous system for refractory left ventricular summit arrhythmias

Enriquez,

Hanson,

Nazer

et al. 2024

Heart Rhythm O2

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“…This setup allows delivery of "multipolar" ablation and thus likely achieves higher current density in the area of interest without the requirement of additional equipment other than the 2Fr octapolar catheter. Feasibility and safety were demonstrated in a clinical case report [ 59 ].…”

Section: Advanced Radiofrequency Techniques: Exploring the Full Poten...mentioning

confidence: 99%

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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Help from the little guy: Intramural ischemic ventricular tachycardia ablation leveraging a 2F multipolar catheter in a coronary vein

Blackwell,

Estes,

Shalaby

2024

HeartRhythm Case Reports

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Multipolar Ablation Using Mapping Electrodes

Cited by 3 publications

References 7 publications

Bipolar ablation involving coronary venous system for refractory left ventricular summit arrhythmias

Bipolar ablation involving coronary venous system for refractory left ventricular summit arrhythmias

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

Help from the little guy: Intramural ischemic ventricular tachycardia ablation leveraging a 2F multipolar catheter in a coronary vein

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