Introduction
Radiofrequency catheter ablation (RFCA) is an effective and safe therapy
for idiopathic ventricular arrhythmias (VAs). However, the ablation of
VAs originating from the left ventricular epicardium adjacent to the
transitional area from the great cardiac vein to the anterior
interventricular vein (DGCV-AIV) can be challenging because of the
complex anatomic structures of this region (adjacent to coronary
arteries) and difficulty in manipulation of the ablation catheter in the
small-lumen and tortuous coronary venous
system[1,2].
It is reasonable to assume that any approach, which could assist
ablation catheter going through the anatomic obstacles in the coronary
venous system and aid catheter tip reaching more distal portion of
DGCV-AIV, would improve the success rate of RFCA. Nevertheless, up to
now, no systemic studies investigated the most appropriate manipulation
approach for RFCA of VAs arising from DGCV-AIV.
Recent studies revealed that application of Swartz sheath could improve
stability of catheter manipulation and enhance mapping and ablation
efficiency in RFCA for VAs, for example,
reversed U-curve technique of
ablation catheter with the support of Swartz sheath for PSCs
VAs[3], reversed S-curve technique of ablation
catheter with the support of Swartz sheath close to the fossa ovalis for
endocardial LV summit VAs[4]. Thus, we doubt
whether the Swartz sheath support approach could be utilized in RFCA of
DGCV-AIV VAs to achieve a more efficient ablation.
In this study, we aimed to evaluate the value and safety of the Swartz
sheath support approach in mapping and ablation of DGCV-AIV VAs.