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Pulsed Field Ablation is a relatively new modality for treatment of atrial fibrillation. In conventional ablation for atrial fibrillation, either heating of tissue is produced by radiofrequency application or freezing of tissues by cryoablation. Pulsed field ablation group had 305 patients while thermal ablation group had 302 patients.
Radiofrequency catheter ablation is highly effective (85%-90%) in those with severe symptoms. Either case, the treatment is ablation of the right bundle. Idiopathic right ventricular outflow tract VT responds to beta-blockers and verapamil, but the current therapy of choice is radiofrequency catheter ablation.
Chronic recurrent monomorphic VT like fascicular tachycardia and right ventricular outflow tract tachycardia are also amenable to electrophysiological mapping and ablation. Recurrent ventricular tachycardia in spite of radiofrequency catheter ablation needs an implantable cardioverter defibrillator.
Electrophysiological study will show that, and this pathway can be ablated. Periprocedural electrophysiological study and ablation of potential arrhythmic circuits, have been suggested as a preventive strategy. This is one important cause of supraventricular tachycardia in Ebstein’s anomaly.
Ablation catheter is different from the other types of catheters. This is an ablation catheter. This is another view of the same catheter, decapolar catheter in coronary sinus. Quadripolar in His bundle region. These are the two proximal electrodes and these are the two distal electrodes. So this has to have a bigger surface area.
Cases are on record, in which ablation of the fourth septal artery has been done to ameliorate the obstruction in mid cavity obstruction. The role of cath now a days is mostly for septal ablation. Doppler echo showing LVOT gradient in HCM.
Nearly two thirds in the rhythm control strategy were on amiodarone and only 14 had catheter ablation. That is how the strategy of rhythm control by catheter ablation was thought of as a possible better strategy, though technically more challenging, not uniformly effective and having significant risk of complications. N Engl J Med.
Role of cardiac cath is now mostly limited to septal ablation. Though echocardiography is the sheet anchor of diagnosis of hypertrophic cardiomyopathy, clinical evaluation is equally important while deciding management and ruling out differential diagnoses.
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