Successful bipolar radiofrequency catheter ablation (RFCA) of refractory ventricular arrhythmias (VAs) has been reported. However, the efficacy, safety, and long-term outcomes of bipolar RFCA of VAs are yet to be fully determined.
To evaluate the effectiveness and safety of bipolar RFCA in treating refractory VAs during long-term follow-up.
Eighteen patients who underwent bipolar RFCA for ventricular tachycardia (VT) at 7 institutions were retrospectively investigated. Underlying heart diseases included remote myocardial infarction (3 patients, 17%) and non-ischemic cardiomyopathy (15 patients, 83%). Although unipolar RFCA was performed in all patients, either it failed to suppress VT or VT recurred. The interventricular septum, left ventricular free wall, and left ventricular summit were targeted for bipolar RFCA.
Acute success (VT termination and/or non-inducibility) was achieved with bipolar RFCA in 16 patients (89%). Complications during the procedure included complete atrioventricular block (n=2) and coronary artery stenosis (n=1). One patient underwent chemical ablation after bipolar RFCA failure. At 12-month follow-up, VT reoccurred in 8 patients (44%). However, in patients with recurrence, VT burden had decreased, only 4 patients underwent re-RFCA, and only 1 out of 4 required chemical ablation. In the remaining 4 patients, re-RFCA was not required, as VT was controlled by medication or an implantable cardioverter defibrillator.
Bipolar RFCA is useful in the acute suppression of refractory VT. While VT recurrence rates during long-term follow-up were relatively high, we observed a significant reduction in VT burden.
Copyright © 2020. Published by Elsevier Inc.