Mapping and ablation of intramural ventricular tachycardia (VT) remain a challenge. We developed a trans‐myocardial electrogram recording across distal tips of two separate ablation catheters placed on contralateral sides of the myocardium to record a trans‐myocardial bipole and a novel pacing electrode configuration. This trans‐myocardial bipole was applied during bipolar ablation in a patient with septal VT. Local activation in this trans‐myocardial bipole was similar to the earliest activation recorded from detailed activation maps from both sides of the septum. Pacing from this trans‐myocardial bipole resulted in a perfect morphology match. After bipolar ablation, the trans‐myocardial bipolar voltage decreased by 82%, and pacing threshold increased by 800%. These findings correlated with VT noninducibility.

中文翻译：

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跨心肌双极电图：深部病灶双极消融的映射和确定疗效的策略。

壁内室性心动过速 (VT) 的标测和消融仍然是一个挑战。我们开发了跨心肌对侧放置的两个独立消融导管远端尖端的跨心肌电图记录，以记录跨心肌双极和新型起搏电极配置。这种跨心肌双极在患有室间隔 VT 的患者的双极消融期间应用。这种跨心肌双极的局部激活类似于从隔膜两侧的详细激活图中记录的最早激活。从这个跨心肌双极起搏导致完美的形态匹配。双极消融后，跨心肌双极电压下降82%，起搏阈值上升800%。这些发现与 VT 不可诱导性相关。