To the Editor — Temperature measurement from both electrodes during bipolar radiofrequency ablation—It is feasible
We have read with interest a recent HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias, particularly a chapter on bipolar radiofrequency catheter ablation. The authors state that one of the limitations of this emerging approach is the fact that temperature measurements can be obtained only from 1 of 2 catheters used.1 Actually this can be done if temperature data from the thermistor located at the tip of catheter used as a ground are transferred to a temperature monitor (ie, a second radiofrequency generator).
Conclusion: Consecutive recording of six single-lead ECGs including Einthoven and Wilson-like leads by a smartwatch is feasible with good ECG signal quality. Thus, this simulated six-lead smartwatch ECG may be useable for the detection of cardiac diseases necessitating more than one ECG lead like myocardial ischemia or more complex cardia arrhythmias.
ConclusionsSmall but detectable very low ‐voltage areas during mapping in sinus rhythm characterize the arrhythmogenic substrate of idiopathic RVOT VAs and may guide successful catheter ablation.
This study investigated whether high ‐density endocardial bipolar voltage mapping of the right ventricular outflow tract (RVOT) during sinus rhythm may guide catheter ablation of idiopathic ventricular arrhythmias (VAs).Methods and ResultsForty ‐four patients (18 males, mean age 38.1±13.8) with idiopathic RVOT VAs and negative cardiac magnetic resonance imaging underwent a stepwise mapping approach for the identification of the site of origin (SOO). High‐density electronatomical mapping (1096.6±322.3 points) was performed during sinu s rhythm and identified at least two low bipolar voltage areas
AbstractWe have developed a system that could potentially be used to identify the site of origin of ventricular tachycardia (VT) and to guide a catheter to that site to deliver radio-frequency ablation therapy. This system employs the Inverse Solution Guidance Algorithm based upon Single Equivalent Moving Dipole (SEMD) localization method. The system was evaluated inin vivo swine experiments. Arrays consisting of 9 or 16 bipolar epicardial electrodes and an additional mid-myocardial pacing lead were sutured to each ventricle. Focal tachycardia was simulated by applying pacing pulses to each epicardial electrode at multiple...
AbstractPurposeIn arrhythmogenic right ventricular cardiomyopathy (ARVC), abnormal electroanatomic mapping (EAM) areas are proportional to extent of T-wave inversion on 12-lead ECG. We aimed to evaluate local repolarization changes and their relationship to EAM substrate in ARVC.MethodsUsing unipolar recordings, we analyzed the proportion of negative T waves ≥ 1 mV in depth (NegT), NegT area, Q-Tpeak (QTP), Tpeak-Tend (TPE) intervals and their relationship to bipolar (
ConclusionsBipolar RFCA from coronary veins and an opposite endocardium can be used for safe and successful treatment of PVC/VT originating from a deep LV summit.
Refers to: 2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias. Heart Rhythm. 2019 May 8. pii: S1547-5271(19)30210-3. https://doi.org/10.1016/j.hrthm.2019.03.002.
We thank Drs. Futyma and Ku łakowski for their interest in the recently published 2019 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Catheter Ablation of Ventricular Arrhythmias and further thank the authors for bringing to our attention their work on catheter tip size, which was published after completion of the clinica l document.1 We agree that temperature monitoring of both catheter tips is possible, but that such a system is not yet, to our knowledge, commercially available or approved. Monitoring of impedance and temperature during bipolar catheter ablation is not straightforward and the optimal setup and para ...
We thank Drs Futyma and Ku łakowski for their interest in the recently published 2019 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Catheter Ablation of Ventricular Arrhythmias and further thank the authors for bringing to our attention their work on catheter tip size, which was published after the completion of the cli nical document.1 We agree that temperature monitoring of both catheter tips is possible, but that such a system is not yet, to our knowledge, commercially available or approved.
Objective : The most relevant source of signal contamination in the cardiac electrophysiology (EP) laboratory is the ubiquitous powerline interference (PLI). To reduce this perturbation, algorithms including common fixed-bandwidth and adaptive-notch filters have been proposed. Although such methods have proven to add artificial fractionation to intra-atrial electrograms (EGMs), they are still frequently used. However, such morphological alteration can conceal the accurate interpretation of EGMs, specially to evaluate the mechanisms supporting atrial fibrillation (AF), which is the most common cardiac arrhythmia. Give...