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Use of a closed loop irrigated catheter in epicardial ablation of ventricular tachycardia

Journal of Interventional Cardiac Electrophysiology volume 38, pages 35–42 (2013)Cite this article

Abstract

Purpose

Catheter ablation of ventricular tachycardia (VT) often requires a combined epicardial and endocardial approach. An open irrigated catheter for epicardial ablation of ventricular tachycardia is commonly used. However, this can be associated with problems of fluid accumulation in the pericardial space necessitating repeated aspirations and interfering with catheter–tissue contact. A closed loop irrigated catheter can be a viable alternative to overcome these problems. We report our first three cases of epicardial VT ablation using a closed loop irrigated ablation catheter (Chilli II, Boston Scientific).

Methods

Catheter ablation of ventricular tachycardia was performed via epicardial and endocardial approaches using a closed loop irrigated ablation catheter (Chilli II, Boston Scientific) and using 3-D mapping with EnSite/NavX system. Patients were routinely followed up after the catheter ablation procedure in clinic for any recurrence of ventricular arrhythmia.

Results

We report our first three cases of epicardial VT ablation using a closed loop irrigated ablation catheter. Power delivery was adequate with mean power of 15.2 ± 2.8, 31.1 ± 3.8, and 25.0 ± 3.3 W, respectively, in the three patients. No impedance rises were noted during the lesion formation. There was no recurrence of VT in any of the patients after 3 months of follow-up.

Conclusions

To our knowledge, we report the first case series of epicardial VT ablation using a closed loop irrigated catheter and the EnSite/NavX mapping system. The advantages of closed irrigation, especially in conjunction with impedance-based anatomical mapping, warrant further study of its efficacy in catheter ablation from the pericardial space.

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Conflict of interest

J Paul Mounsey is a paid speaker and consultant to Boston Scientific and St Jude Medical, while the rest of the authors have no conflict of interest.

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Affiliations

  1. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Prabhat Kumar, J. Paul Mounsey, Anil K. Gehi, Jennifer D. Schwartz & Eugene H. Chung

  2. Division of Cardiology and Cardiac Electrophysiology, University of North Carolina at Chapel Hill, 160 Dental Circle, CB 7075, Chapel Hill, NC, 27599, USA

    Prabhat Kumar

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  1. Prabhat Kumar
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  2. J. Paul Mounsey
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  3. Anil K. Gehi
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  4. Jennifer D. Schwartz
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  5. Eugene H. Chung
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Correspondence to Prabhat Kumar.

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Kumar, P., Mounsey, J.P., Gehi, A.K. et al. Use of a closed loop irrigated catheter in epicardial ablation of ventricular tachycardia. J Interv Card Electrophysiol 38, 35–42 (2013). https://doi.org/10.1007/s10840-013-9799-1

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  • DOI: https://doi.org/10.1007/s10840-013-9799-1

Keywords

  • Epicardial ablation
  • Ventricular tachycardia
  • Closed loop irrigated catheter