Pacing and clinical electrophysiology : PACE
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In recent years several trials demonstrated the efficacy of implantable cardioverter-defibrillation (ICD) therapy in reducing cardiac and total mortality in patients affected by rapid ventricular tachycardia (VT) and/or ventricular fibrillation. Nevertheless, ICD do not prevent arrhythmia recurrences, thus being a palliative and not a curative treatment modality. The tolerance to ICD therapy varies greatly, and within individuals, this leading to a nonuniform acceptance of this form of therapy. ⋯ In experienced centers, RFCA is now performed, regardless of whether the VT rate is rapid and/or is hemodynamically unstable. Newer mapping and ablation techniques are now available, enhancing the acute success rate of the procedure. In this review the most recent application of VT catheter ablation and the use of advanced mapping and ablation techniques will be discussed.
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Pacing Clin Electrophysiol · Dec 2006
Comparative StudyConvective cooling effect on cooled-tip catheter compared to large-tip catheter radiofrequency ablation.
Both actively cooled-tip and large-tip catheters are currently available clinically to create large endomyocardial lesions during application of radiofrequency (RF) energy. The purpose of this study was to compare the effect of convective cooling at physiologic flow rates on RF lesion size using both actively cooled and large-tip catheters. ⋯ During RF ablation, blood flow rate significantly affects lesion size for large-tip but not cooled-tip catheters. At low flow rates (0-1 L/min) cooled-tip catheters create larger lesions, while at high flow rates (3 L/min) large-tip catheters create larger lesions.