Bipolar Endo-Epicardial Radiofrequency Ablation of Therapy-Resistant Ventricular Arrhythmias

Despite extensive conventional endoepicardial ablation, significant intramural arrhythmogenic substrate may remain out of reach of unipolar radiofrequency ablation (RFA). The authors present clinical findings and procedural workflow for bipolar radiofrequency ablation (B-RFA) with 1 catheter placed against the endocardium and the other in the pericardial sac to ablate refractory ventricular arrhythmias. No serious adverse events occurred during B-RFA procedures, and the short-term and midterm clinical results were satisfactory. Optimal catheter choice and ablation parameters settings for B-RFA remain to be determined.