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Intermediate Technical IVT

Bidirectional Block

Complete interruption of electrical conduction in both directions across a line of ablation, confirming successful isolation of cardiac tissue.

Full Definition

Bidirectional block refers to the complete interruption of electrical conduction in both directions across an ablation line or anatomical barrier. This is a critical endpoint in many ablation procedures, particularly pulmonary vein isolation and linear ablation strategies. Testing involves pacing from both sides of the ablation line to confirm that electrical impulses cannot propagate across the lesion set. Achievement of bidirectional block is associated with improved long-term success rates and reduced arrhythmia recurrence.

Usage

Usage note: Always verify using pacing from both sides of the ablation line. Essential endpoint for linear ablation strategies.

In Context

  • "Bidirectional block was confirmed across the posterior wall line with differential pacing maneuvers." — Ablation report
  • "The procedure was deemed successful only after achieving bidirectional block at all pulmonary vein antra." — Operative note

Also known as

complete block transmural block

Contrasted with

conduction gap incomplete block

Don't confuse with

unidirectional block entrance block

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