Clinical use of cooled radiofrequency ablation.

Irrigated (cooled) radiofrequency (RF) ablation has become our primary ablation tool for treating atrial fibrillation, macroreentrant atrial tachycardias, and scar-related ventricular tachycardias. As with any technology that increases ablation lesion size, there is the potential for increased risk. The methods described are a cautious approach to power titration that considers the risks of excessive heating and the lesion size needed for a particular site. Future methods of assessing lesion creation will hopefully refine energy titration to improve safety and efficacy of cooled RF ablation.