A minority of premature ventricular contractions (PVC) and ventricular tachycardias (VT) have an intramural origin, which represents a challenge for conventional radiofrequency ablation. Bipolar ablation has the potential ability to create deeper and more transmural lesions and has been demonstrated to be optimal treatment in these cases. Bipolar ablation carries a relatively low risk of complications and is effective in eliminating or reducing the burden of ventricular arrhythmias. Despite its utility and efficacy, the clinical use of bipolar ablation is limited, and B-RF technology is still investigational and not widely available. This article reviews the technique of bipolar ablation and all its advantages when applied to specific scenarios.
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http://dx.doi.org/10.31083/j.rcm2305179 | DOI Listing |
J Clin Med
January 2025
Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, 47121 Romagna, Italy.
Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) is a promising minimally invasive technique for the treatment of pancreatic lesions. This review first focuses on the technical aspects in EUS-RFA: the procedure typically employs EUS probes with integrated radiofrequency electrodes, enabling accurate targeting and ablation of pancreatic lesions. Different types of RFA devices, monopolar and bipolar energy delivery systems, are discussed, along with considerations for optimal ablation, including energy settings, procedure time, and pre- and post-procedural management.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
January 2025
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Background: Pulsed-field ablation (PFA) is an innovative non-thermal method for arrhythmia treatment. The efficacy of various PFA configurations in relation to contact force (CF) has not been well-studied in vivo.
Objectives: This study evaluated the effect of CF on acute bipolar PFA lesions in both a vegetal and an in vivo porcine heart model.
Circ Arrhythm Electrophysiol
January 2025
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.H., M.E.R., O.Y., G.N.K., N.O., T.K., L.N., D.L.P., K.C.S.).
Background: Power-controlled radiofrequency ablation with irrigated-tip catheters has been the norm for ventricular ablation for almost 2 decades. New catheter technology has recently integrated more accurate tissue temperature sensing enabling temperature-controlled irrigated ablation. We aimed to investigate the in vivo ablation parameters and lesion formation characteristics in ventricular myocardium using a novel temperature-controlled radiofrequency catheter.
View Article and Find Full Text PDFJACC Clin Electrophysiol
January 2025
Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia; Westmead Applied Research Centre, University of Sydney, Sydney, New South Wales, Australia. Electronic address:
Background: Accurate electroanatomic mapping is critical for identifying scar and the long-term success of ventricular tachycardia ablation.
Objectives: This study sought to determine the accuracy of multielectrode mapping (MEM) catheters to identify scar on cardiac magnetic resonance (CMR) and histopathology.
Methods: In an ovine model of myocardial infarction, we examined the effect of electrode size, spacing, and mapping rhythm on scar identification compared to CMR and histopathology using 5 multielectrode mapping catheters.
J Magn Reson Imaging
January 2025
Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA.
This review covers the theoretical background, pulse sequence considerations, practical implementations, and multitudes of applications of magnetic resonance acoustic radiation force imaging (MR-ARFI) described to date. MR-ARFI is an approach to encode tissue displacement caused by the acoustic radiation force of a focused ultrasound field into the phase of a MR image. The displacement encoding is done with motion encoding gradients (MEG) which have traditionally been added to spin echo-type and gradient recalled echo-type pulse sequences.
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