Hands On
Retrograde venous ethanol ablation for ventricular tachycardia
Radiofrequency catheter ablation (RFCA) has been considered the first-line therapy for treatment of drug-refractory ventricular arrhythmias (VAs).1 The success of catheter ablation depends on our ability to reach the anatomic location of the ventricular tachycardia (VT) substrate. VTs arising from deep intramural regions2 or in close proximity to coronary vessels3 can have limited RFCA success. Transarterial coronary ethanol ablation has been used as an alternative treatment option and is reasonably successful in treating RFCA-refractory VTs.Epicardial substrate ablation for Brugada syndrome
Brugada syndrome (BrS), characterized by the presence of coved-type ST-segment elevation followed by T-wave inversion in the right precordial electrocardiogram (ECG) leads in patients who have no structural heart disease but have a high risk of sudden cardiac death from ventricular fibrillation (VF), has captivated arrhythmia scholars and electrophysiologists for more than 2 decades. As a result, major progresses have been made toward a better understanding of the syndrome with respect to its genetic basis, underlying pathophysiology, and risk stratification.
