Epicardial Mapping and Ablation in Management of Ventricular Tachycardia

Ventricular tachyarrhythmias are among the main problems in cardiology and electrophysiology. Drugs treatment is often ineffective in patients with ventricular tachycardia (VT), while interventional approach is more successful. Nevertheless, despite the progress in visualization and catheter ablation technologies, there is still significant ventricular tachycardia recurrence rate over time. There is a number of reports showing that the main cause of endocardial ablation failure is deep intramural and subepicardial location of arrhythmogenic foci. An elegant percutaneous technique using a subxyphoid access has been proposed in order to reach the pericardial space. Combination of endoand epicardial mapping and ablation has revolutionized ventricular tachycardia management in patients with structural heart diseases, allowing much better success in specific patient population. This review summarizes current achievements in epicardial mapping and ablation in complex ventricular tachycardia management.