title: Clinical and biophysical evaluation of variable bipolar configurations during radiofrequency ablation for treatment of ventricular arrhythmias.
abstract: Bipolar radiofrequency ablation (bRFA) has been used to create larger ablation lesions and to treat refractory arrhythmias. However, little is known about optimal bRFA settings.
  
  
  
  The purpose of this study was to evaluate various bRFA settings, including active and ground catheter tip orientation and use of variable active and ground catheters during bRFA.
  
  
  
  Two ablation catheters, 1 active and 1 ground, were oriented across from each other, with viable bovine myocardium in between. The catheter tips were placed in various combinations perpendicular or parallel to the myocardium. The active catheter was either a 3.5-mm externally irrigated or 8-mm tip, and the ground catheter was either a 4-mm, 3.5-mm irrigated, or 8-mm tip. Retrospective analysis was undertaken for all bRFA performed at University of Colorado.
  
  
  
  The largest and deepest lesions were produced using irrigated active and ground tips, oriented perpendicularly. In 14 cases (10 patients) of bRFA for ventricular tachycardia and premature ventricular complexes, acute success was achieved in 13 of 14 procedures. Long-term success was achieved in 7 of 10 patients, but 3 patients required multiple bRFA ablations.
  
  
  
  Active and ground catheter tip orientation and type are important determinants of lesion sizes during bRFA. The largest and deepest lesions, without a higher incidence of steam pops, were achieved using 2 irrigated catheters. As the largest published series to date, bRFA ablation can be performed safely and effectively in humans. Larger studies are necessary to better evaluate bRFA efficacy and safety.
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora, Colorado.
authors.forename: Duy T
authors.initials: DT
authors.lastname: Nguyen
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora, Colorado.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Tzou
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora, Colorado.
authors.forename: Michael
authors.initials: M
authors.lastname: Brunnquell
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora, Colorado.
authors.forename: Matthew
authors.initials: M
authors.lastname: Zipse
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora, Colorado.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Schuller
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora, Colorado.
authors.forename: Lijun
authors.initials: L
authors.lastname: Zheng
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora, Colorado.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Aleong
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora, Colorado. Electronic address: william.sauer@ucdenver.edu.
authors.forename: William H
authors.initials: WH
authors.lastname: Sauer
mesh_terms: D000818:Animals; D062906:Cardiac Catheters; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods; D002417:Cattle; D004867:Equipment Design; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery; D008422:Materials Testing; D008955:Models, Cardiovascular; D017755:Prosthesis Fitting; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery
keywords: Active and Ground Catheters; Arrhythmia; Bipolar radiofrequency ablation; Radiofrequency; Ventricular tachycardia