Table 1.

(Dis)advantages of bipolar and ethanol ablation

Ablation strategy	Advantages	Disadvantages
Bipolar ablation	•Possibility of creating a transmural/intramural lesion •Lesion size more predictable •Transseptal approach preferred in ischemic cardiomyopathy	•Risk of conduction damage for basal intramural septal focus •No electro-anatomical mapping (EAM) system visualization, contact force, and vector information of catheter tips •Difficult to interpret good position on fluoroscopy only •No local intramural information •Irreversible effect •Special setup needed11 •High cost of 2 new ablation catheters
Ethanol ablation	•More published data describing techniques and results10, 12 •Possibility of creating a transmural/intramural lesion •Reversible evaluation of the effect using iced saline •Local unipolar recording of guidewire possible •Low cost (no extra catheters or steerable sheath needed) •Available in case of failed epicardial access	•Limited by coronary anatomy •Retrograde approach needed in ischemic cardiomyopathy (possible silent emboli) •Iatrogenic final infarct size not always predictable •Risk of irreversible conduction block if not preceded by saline •Risk of ethanol leak in the nontargeted artery