Bipolar Radiofrequency Ablation of Refractory Ventricular Arrhythmias: Results from a Multicenter Network.
Year: 2024
Type: article
Abstract: Background Advanced ablation strategies are needed to treat ventricular tachycardia (VT) and premature ventricular contractions (PVC) refractory to standard unipolar radiofrequency ablation (Uni-RFA). Bipolar radiofrequency catheter ablation (Bi-RFA) has emerged as a treatment option for refractory VT, PVC. Multicenter registry data on the use of Bi-RFA in the setting of refractory VT and PVC are lacking.Purpose The aim of this Bi-RFA registry is to determine its real-world safety, feasibility, and efficacy in patients with refractory VT/PVC.Methods Consecutive patients undergoing Bi-RFA at sixteen European centers for recurring VT/PVC after at least one standard Uni-RFA were included. Second ablation catheter was used instead of a dispersive patch and was positioned at the opposite site of the ablation target.Results Between March 2021 and August 2024, ninety-one patients underwent 94 Bi-RFA procedures (74 males, age 62±13, prior Uni-RFA range 1-8). Indications were recurrence of PVC (n=56), VT (n=20), electrical storm (n=13), or PVC-triggered ventricular fibrillation (n=2). Procedural time was 160±73min, Bi-RFA time 426±286s, mean Uni-RFA time 819±697s. Elimination of clinical VT/PVC was achieved in 67 (74%) patients, suppression of VT/PVC in a further 10 (11%) patients. In the remaining 14 patients (15%) no effect on VT/PVC was observed. Three major complications occurred: coronary artery occlusion, AV block and arteriovenous fistula. Follow-up lasted 7±8 months. Nineteen (61%) remained VT-free. ≥80% PVC burden reduction was achieved in 45 (78%).Conclusions This real-world registry data indicates that Bi-RFA appears safe, is feasible, and effective in the majority of patients with VT/PVC.
DOI: 10.48620/76008
Authors: Futyma, Piotr, Sultan, Arian, Zarębski, Łukasz, Imnadze, Guram, Maslova, Vera, Bordignon, Stefano, Kousta, Maria, Knecht, Sven, Pavlović, Nikola, Peichl, Petr, Lian, Evgeny, Kueffer, Thomas, Scherr, Daniel, Pfeffer, Michael, Moskal, Paweł, Gabriel, Cismaru, Antolič, Bor, Wałek, Paweł, Chen, Shaojie, Martinek, Martin, Kollias, Georgios, Derndorfer, Michael, Seidl, Sebastian, Schmidt, Boris, Lüker, Jakob, Steven, Daniel, Sommer, Philipp, Jastrzębski, Marek, Kautzner, Josef, Reichlin, Tobias, Sticherling, Christian, Pürerfellner, Helmut, Enriquez, Andres, Wörmann, Jonas, Chun, Julian K R
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W6892009491
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