Key result
Conventional radiofrequency catheter ablation can sometimes be insufficient to achieve expected lesion depth in septal accessory pathways, suggesting a role for bipolar ablation.
Why the study?
Does bipolar radiofrequency catheter ablation improve termination of conduction in patients with high-risk posteroseptal accessory pathways compared to conventional ablation?
Does bipolar radiofrequency catheter ablation improve termination of conduction in patients with high-risk posteroseptal accessory pathways compared to conventional ablation?
Bipolar ablation may offer an alternative for high-risk posteroseptal accessory pathways where conventional radiofrequency ablation fails to achieve sufficient lesion depth.
Bipolar ablation may be considered for refractory septal pathways; leaves open need for randomized comparisons.
Radiofrequency catheter ablation (RFCA) of accessory pathways (AP) is a well-established method of treatment of patients with Wolff-Parkinson-White syndrome. APs with effective refractory period ≤250 ms are considered at high risk of sudden cardiac death; thus RFCA of these pathways is highly recommended.1 The main goal of conventional ablation is to terminate conduction through the AP, which is created by RF current. However, owing to variable anatomical and biophysical properties of targeted tissue, conventional RFCA can sometimes be insufficient to achieve an expected lesion depth, especially in some septal APs.
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Futyma et al. (2019) conducted an editorial in Wolff-Parkinson-White syndrome. Bipolar radiofrequency catheter ablation vs. Conventional radiofrequency catheter ablation was evaluated. Conventional radiofrequency catheter ablation can sometimes be insufficient to achieve expected lesion depth in septal accessory pathways, suggesting a role for bipolar ablation.
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