Content for healthcare professionals only
Rhythm Interventions Online
The world's largest virtual arrhythmia event
Content for healthcare professionals only
Session 4.5 - Case & Discussion: Bipolar Ablation as a Therapeutic Strategy for Premature Ventricular Contractions
This session, chaired by Bishnu Dhakal (North Charleston, US), presents a case of Bipolar Ablation as a Therapeutic Strategy for PVCs in a patient with non-ischaemic cardiomyopathy and intramural LV summit PVCs, where endocardial and epicardial-adjacent unipolar RF delivered from the LVOT and coronary sinus only modified the PVC, but carefully planned bipolar ablation between an LVOT catheter and a coronary sinus catheter—using precise catheter spacing, vector alignment and coronary angiography—achieved rapid, durable PVC elimination. In discussion, Fermin Garcia (Philadelphia, US) and Andre d’Avila (Boston, US) emphasise the need to understand epicardial fat, intramural substrate and current flow, to reserve bipolar ablation for truly refractory cases, and to prioritise safety by monitoring distance to coronary arteries, conduction system and valve apparatus, while moderator Devi Nair (Jonesboro, US) highlights that success with bipolar ablation depends more on geometry and careful biophysics than on simply increasing power.
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