Bipolar Endo-Epicardial Radiofrequency Ablation of Therapy-Resistant Ventricular Arrhythmias: A Brief Case Series

Paweł Derejko; Jacek Kuśnierz; Aleksander Bardyszewski; Dobromiła Dzwonkowska; Magdalena Polańska-Skrzypczyk; Łukasz Jan Szumowski; Atul Verma

doi:10.1016/j.jacep.2023.02.026

Bipolar Endo-Epicardial Radiofrequency Ablation of Therapy-Resistant Ventricular Arrhythmias: A Brief Case Series

JACC Clin Electrophysiol. 2023 Jun;9(6):733-737. doi: 10.1016/j.jacep.2023.02.026. Epub 2023 May 24.

Authors

Paweł Derejko¹, Jacek Kuśnierz², Aleksander Bardyszewski², Dobromiła Dzwonkowska², Magdalena Polańska-Skrzypczyk², Łukasz Jan Szumowski³, Atul Verma⁴

Affiliations

¹ Cardiac Arrhythmias Department, National Institute of Cardiology, Warsaw, Poland; Department of Cardiology, Medicover Hospital, Warsaw, Poland. Electronic address: [email protected].
² Department of Cardiology, Medicover Hospital, Warsaw, Poland.
³ Cardiac Arrhythmias Department, National Institute of Cardiology, Warsaw, Poland.
⁴ Division of Cardiology, McGill University Health Centre, Montreal, Canada.

PMID: 37227350
DOI: 10.1016/j.jacep.2023.02.026

Abstract

Despite extensive conventional endoepicardial ablation, significant intramural arrhythmogenic substrate may remain out of reach of unipolar radiofrequency ablation (RFA). The authors present clinical findings and procedural workflow for bipolar radiofrequency ablation (B-RFA) with 1 catheter placed against the endocardium and the other in the pericardial sac to ablate refractory ventricular arrhythmias. No serious adverse events occurred during B-RFA procedures, and the short-term and midterm clinical results were satisfactory. Optimal catheter choice and ablation parameters settings for B-RFA remain to be determined.

Keywords: bipolar ablation; endo-epicardial ablation; epicardial access; ventricular tachycardia.

Publication types

Review

MeSH terms

Arrhythmias, Cardiac
Catheter Ablation* / methods
Humans
Pericardium / surgery
Tachycardia, Ventricular*
Treatment Outcome