Shalaby Alaa A, Hendawy Bassem S, Wann Daniel G, Bhonsale Aditya, Kancharla Krishna, Voigt Andrew, Jain Sandeep, Estes Mark, Saba Samir, Aronis Konstantinos N
Division of Cardiac Electrophysiology, Heart and Vascular Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Divisions of Transplantation, Hepatic and Renal Pathology/Thomas E. Starzl Institute University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
J Cardiovasc Electrophysiol. 2025 Aug;36(8):2068-2072. doi: 10.1111/jce.16721. Epub 2025 Jun 5.
Bipolar radiofrequency ablation has been increasingly used in cases with deep intramyocardial circuits refractory to unipolar ablation. Patients with Lamin A/C cardiomyopathy frequently exhibit VT arrhythmia originating from deep in the interventricular septum.
We describe our use of bipolar ablation in a patient with nonischemic cardiomyopathy and Lamin A/C mutation for the treatment of a septal VT substrate with particular attention to pathology findings at 3 months.
Bipolar ablation with catheters across the septum and in the presence of a microcatheter in a septal branch of the anterior interventricular vein was effective in controlling ventricular arrhythmia. Resultant ablation resulted in extensive myocardial injury and fibrosis. Neointimal hyperplasia of intervening coronary arteries may play a role in subsequent effects of initial ablation lesions.
双极射频消融术在单极消融难以处理的深层心肌内环路病例中的应用日益增多。 lamin A/C 心肌病患者常出现源于室间隔深部的室性心动过速心律失常。
我们描述了在一名患有非缺血性心肌病和 lamin A/C 突变的患者中使用双极消融术治疗室间隔室性心动过速基质的情况，并特别关注 3 个月时的病理结果。
通过跨间隔导管并在前室间静脉的间隔分支中使用微导管进行双极消融术可有效控制室性心律失常。由此产生的消融导致广泛的心肌损伤和纤维化。介入冠状动脉的新生内膜增生可能在初始消融损伤的后续影响中起作用。
