Acute and long-term results of bipolar radiofrequency catheter ablation of refractory ventricular arrhythmias of deep intramural origin

被引：51

作者：

Igarashi, Miyako ^{[1
]}

Nogami, Akihiko ^{[1
]}

Fukamizu, Seiji ^{[2
]}

Sekiguchi, Yukio ^{[1
]}

Nitta, Junichi ^{[3
]}

Sakamoto, Naka ^{[4
]}

Sakamoto, Yuichiro ^{[5
]}

Kurosaki, Kenji ^{[6
]}

Takahashi, Yoshihide ^{[7
]}

Kimata, Akira ^{[1
]}

Komatsu, Yuki ^{[1
]}

Machino, Takeshi ^{[1
]}

Kuroki, Kenji ^{[1
]}

Yamasaki, Hiro ^{[1
]}

Aonuma, Kazutaka ^{[1
]}

Ieda, Masaki ^{[1
]}

机构：

[1] Univ Tsukuba, Dept Cardiol, Fac Med, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058575, Japan

[2] Tokyo Metropolitan Hiroo Gen Hosp, Dept Cardiol, Tokyo, Japan

[3] Saitama Red Cross Hosp, Dept Cardiol, Saitama, Japan

[4] Asahikawa Med Univ, Dept Cardiol, Asahikawa, Hokkaido, Japan

[5] Toyohashi Heart Ctr, Dept Cardiol, Toyohashi, Aichi, Japan

[6] Yokohama Rosai Hosp, Dept Heart Rhythm Management, Yokohama, Kanagawa, Japan

[7] Disaster Med Ctr, Dept Cardiovasc Med, Tokyo, Japan

来源：

HEART RHYTHM | 2020年 / 17卷 / 09期

关键词：

Bipolar ablation; Complication; Outcome; Radiofrequency catheter ablation; Ventricular arrhythmias; TACHYCARDIA ABLATION; ETHANOL ABLATION; SEPTUM; ATRIAL;

D O I：

10.1016/j.hrthm.2020.04.028

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Successful bipolar radiofrequency catheter ablation (RFCA) of refractory ventricular arrhythmias (VAs) has been reported. However, the efficacy, safety, and long-term outcomes of bipolar RFCA of VAs are not fully determined. OBJECTIVE The purpose of this study was to evaluate the effectiveness and safety of bipolar RFCA in treating refractory VAs during long-term follow-up. METHODS Eighteen patients who underwent bipolar RFCA for ventricular tachycardia (VT) at 7 institutions were retrospectively investigated. Underlying heart diseases included remote myocardial infarction (n = 3 [17%]) and nonischemic cardiomyopathy (n = 15 [83%]). Although unipolar RFCA was performed in all patients, either it failed to suppress VT or VT recurred. The interventricular septum, left ventricular free wall, and left ventricular summit were targeted for bipolar RFCA. RESULTS Acute success (VT termination and/or noninducibility) was achieved with bipolar RFCA in 16 patients (89%). Complications during the procedure included complete atrioventricular block (n = 2) and coronary artery stenosis (n = 1). One patient underwent chemical ablation after bipolar RFCA failure. At 12-month followup, VT reoccurred in 8 patients (44%). However, in patients with recurrence, VT burden had decreased: only 4 patients underwent re-RFCA, and only 1 of the 4 required chemical ablation. In the remaining 4 patients, re-RFCA was not required, as VT was controlled by medication or an implantable cardioverter-defibrillator. CONCLUSION Bipolar RFCA is useful for acute suppression of refractory VT. Although VT recurrence rates during long-term followup were relatively high, we observed a significant reduction in VT burden.

引用

页码：1500 / 1507

页数：8

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