title: Feasibility of Rapid Linear-Endocardial and Epicardial Ventricular Ablation Using an Irrigated Multipolar Radiofrequency Ablation Catheter.
abstract: BACKGROUND
  A common strategy for ablation of scar-based ventricular tachycardia is delivering multiple lesions in a linear pattern.
  
  
  RESULTS
  We tested the efficacy of a novel linear irrigated multipolar ablation catheter capable of creating linear lesions with a single application. Healthy swine underwent endocardial and epicardial linear ablation using a novel linear irrigated ablation catheter; control animals underwent focal lesions in a linear pattern over 3.5 cm with an irrigated radiofrequency catheter. The linear catheter contained 7 irrigated electrodes spaced over 3.5 cm and could deliver ≤25 W to each electrode. Linear ablation required significantly less radiofrequency time than focal ablation (56±11 versus 497±110 seconds;P<0.0001). At gross pathology, linear (n=18) epicardial lines were longer than focal (n=8) epicardial lines (3.3±0.7 versus 2.1±0.9 cm;P<0.0005), with greater volume (3.8±2.9 versus 1.5±1.6 cm3;P=0.002). There was no difference between linear (n=22) and focal (n=7) endocardial line length or volume. Gaps (length 2.8±0.9 mm) were present in 53% of focal lines and 0% of linear ablation lines. No perforations, steam pops, or thrombus were noted.
  
  
  CONCLUSIONS
  Compared with sequential focal radiofrequency ablation in a linear pattern, an irrigated multipolar linear ablation catheter safely delivers contiguous endocardial or epicardial lesions without gaps in a single ablation. This catheter shows promise for decreasing ventricular tachycardia ablation procedure time and improving outcome.
authors.affiliation: From the Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California San Francisco.
authors.forename: Babak
authors.initials: B
authors.lastname: Nazer
authors.affiliation: From the Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California San Francisco.
authors.forename: Tomos E
authors.initials: TE
authors.lastname: Walters
authors.affiliation: From the Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California San Francisco.
authors.forename: Srikant
authors.initials: S
authors.lastname: Duggirala
authors.affiliation: From the Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California San Francisco. egerstenfeld@medicine.ucsf.edu.
authors.forename: Edward P
authors.initials: EP
authors.lastname: Gerstenfeld
mesh_terms: D000818:Animals; D006328:Cardiac Catheterization / Q000379:methods; D062906:Cardiac Catheters; D017115:Catheter Ablation / Q000379:methods*; D004195:Disease Models, Animal; D004699:Endocardium / Q000601:surgery; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000601:surgery*; D010496:Pericardium / Q000601:surgery; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013552:Swine; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000601:surgery*
keywords: catheter ablation; electrodes; endocardium; tachycardia; tachycardia, ventricular