Radiofrequency ablation of deep seated outflow tract ventricular tachycardia using custom modified bipolar irrigated radiofrequency ablation setup

Abstract

Trans-catheter radio frequency ablation (RFA) of outflow tract ventricular tachycardia (OTT) has a decent success rate of up to 82%. But the recurrences are possible in half of patients on long term follow-up [1]. Improvement in mapping and RFA technologies try to increase both acute and long-term success rates [2]. RFA catheter with the capacity to show real time tip to tissue contact force has been reported recently in outflow tract tachycardia to create a transmural lesion [3]. Deep seated intramural arrhythmic sources often not reachable by the standard RFA catheters. Failure to ablate such focus even by the irrigated RFA catheters is not uncommon. Bipolar RFA (B-RFA) is necessary in such scenarios. But it is not widely used because of the non-availability of the equipment in all cardiac electrophysiology laboratories (EP-lab). We describe the feasibility of B-RFA in a standard EP-lab by simple modification of the existing RFA circuit.