Irrigated radiofrequency ablation targeting both insertions of the moderator band can successfully eliminate idiopathic ventricular tachycardia originating from this structure.
May support targeting both moderator band insertions with irrigated RF for idiopathic VT; leaves open need for prospective validation.
A 59-year-old woman was referred to the institution with burdens of idiopathic ventricular tachycardia (IVT). Electroanatomic mapping revealed a complex fractionated, high frequency potential with long duration preceding the QRS onset of the IVT. The real end point of ablation was the disappearance of the conduction block of Purkinje potential during the sinus rhythm besides the disappearance of the inducible tachycardia. Location of distal catheter was at the moderator band (MB) by transthoracic echocardiography (TTE). Only irrigated radiofrequency current was delivered at both insertions of the MB which can completely eliminate the IVT.
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Li et al. (2017) studied this question.
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