Multipolar Cardiac Ablation
Is It Time for the Ventricles?
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Point-by-point radiofrequency catheter ablation for scar-related ventricular tachycardia (VT) is frequently laborious and comes with long procedural times.1–3 This is driven, in part, by the time required to traverse the often large substrate with several point-by-point radiofrequency applications. The additional effort needed to optimize each radiofrequency application with regard to contact force, overlap, and duration can also be demanding. Although procedural success still requires operators to locate critical isthmuses and make deep lesions, a reduction in overall radiofrequency and procedure times would be widely welcomed both by operators and by our increasingly sick patients. The world of pulmonary vein isolation on the other hand, having been besieged by long radiofrequency times and reconnection related to gaps, has quickly embraced 1 shot approaches to ablation given their speed and efficacy.4,5
See Article by Nazer et al
In this issue, Nazer et al6 make a case for bringing a similar approach to the world of scar VT ablation. This is particularly relevant given the increasing popularity of strategies, such as scar homogenization, core isolation, etc., where multiple radiofrequency lesions are …