Intramyocardial radiofrequency ablation of ventricular arrhythmias using intracoronary wire mapping and a coronary reentry system: Description of a novel technique
2018
Key Teaching Points
• Ventricular arrhythmias originating from the left ventricular summit and intramyocardially within the interventricular septum pose a serious challenge to catheter ablation, as myocardial thickness, epicardial fat, and coronary vessels impede appropriate radiofrequency energy delivery.
• Intracoronary mapping and subsequent intramyocardial ablation using radiofrequency ablation delivered through a system routinely used to treat coronary artery chronic total occlusions (ie, Stingray LP Coronary CTO Re-Entry System) is feasible and effective.
• Unlike alcohol injection and coil embolization of septal perforator arteries, intramyocardial RF ablation using this technique is a more localized and limited approach with less risk of complete atrioventricular block and less myocardial injury.
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