B-PO02-104 OUTCOMES OF BIPOLAR RADIOFREQUENCY ABLATION FOR SCAR-RELATED INTERATRIAL SEPTAL TACHYCARDIAS REFRACTORY TO CONVENTIONAL RADIOFREQUENCY ABLATION

Abstract

Radiofrequency catheter ablation (RFCA) of scar-related interatrial septal tachycardias (IS-AT) has been associated with high recurrence rates. When conventional RFCA fails, the adjunctive role of bipolar RFCA (Bi-RFCA) to target these arrhythmias is undefined. To describe the outcomes of bipolar RFCA (Bi-RFCA) for scar-related IS-AT refractory to conventional RFCA. We included consecutive patients from two centers who underwent Bi-RFCA for scar-related IS-AT following failure of conventional RFCA. Bi-RFCA was delivered from the earliest activation/best entrainment site and the anatomically opposite side of the atrial septum. A total of 5 patients (age 67 ± 16 years, 2 females, CHA2DS2-VASc:2.4 ± 0.5) underwent Bi-RFCA for scar-related IS-AT following failure of conventional RFCA. All patients had evidence of abnormal septal substrate with bipolar voltage scar (<0.2 mV) and had undergone at least one prior catheter ablation (median 3, range 1-5); 2 patients had prior atrial septal defect patch repair and 2 prior mitral valve surgery. Bi-RFCA (power up to 35W for up to 60 seconds) led to acute elimination of the IS-AT in all patients. There were no peri-procedural complications. During a mean follow up of 13 ± 5 months, 4 out of 5 patients had no arrhythmia recurrence. In patients with scar-related IS-AT refractory to conventional RFCA, Bi-RFCA is a safe and effective technique to achieve acute and long-term arrhythmia suppression.