Future of catheter ablation for complex arrhythmias

Catheter ablation using radiofrequency (RF) and cryo-thermal energy has become widely accepted procedures for treatment of various arrhythmias. Thermal ablation, however, has many limitations and can lead to severe complications. Besides possible complications, the long-term efficacy of standard RF ablation is still limited especially for ventricular tachyarrhythmias. Additional energy forms developed for catheter ablation include microwave, ultrasound, and lasers. And new approaches using RF energy were also introduced such as RF hot balloon, heated saline, half-normal saline, bipolar RF, infusion-needle, and high-current low-density RF ablations. Many of the hyperthermal ablation technologies have encountered safety challenges, most commonly related to a lack of control over the extent of lesion formation. Irreversible electroporation (IRE) may be a promising energy as safer and more effective method for cardiac ablation. However, optimal current waveform for IRE is still undetermined.
In this session, we are going to discuss about the future of catheter ablation for complex arrhythmias. Novel energy source and catheter configurations will continue to improve our ablation capabilities, and this should translate into faster, better, and safer ablation procedures.