Which method is recommended for addressing septal VT/AT?

The bipolar sandwich method is particularly recommended for addressing septal ventricular tachycardia (VT) or atrial tachycardia (AT) due to its effectiveness in creating precise lesions in the myocardium. This method utilizes two electrodes positioned close together to deliver radiofrequency energy, allowing for a more controlled ablation process. This is especially beneficial in the septal region, where structures are closely packed and precision is paramount.

One of the key advantages of the bipolar sandwich technique is its ability to minimize damage to surrounding tissue, which is crucial when working near critical cardiac structures. The tighter control over ablative energy and the ability to create deeper lesions contribute to the method's effectiveness in treating arrhythmias that arise from the septal area.

Moreover, the bipolar approach reduces the risk of thermal injury, which is a vital consideration in delicate anatomical regions such as the septum. By creating a more focused ablation zone, the method enhances the chances of successful arrhythmia termination while preserving normal cardiac function.

In contrast, the other methods listed may not provide the same level of precision or safety in the context of septal VT/AT, which is why the bipolar sandwich method is preferred.