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This document is a copyright transfer and author contribution form and contains no clinical study data.
Percutaneous epicardial mapping and ablation is a viable non-surgical approach for epicardial VT, requiring specific techniques and safety precautions compared to endocardial ablation.
Provides no clinical data; leaves open questions on epicardial VT ablation techniques and safety.
In ventricular tachycardia (VT) arising in the myocardial tissue, the site of origin may be the endocardium, mid-myocardium or epicardium. The incidence of epicardial origin varies with the underlying heart disease, and is probably not more than 20% in ischemic heart disease and higher in non-ischemic cardiomyopathies. Percutaneous subxiphoid access to the pericardial space has enabled a non-surgical approach to catheter mapping and ablation of epicardial VT. Several algorithms are available for electrocardiographic recognition of epicardial origin. Idiopathic epicardial VTs are rare but may be curable by catheter ablation. The electrophysiologic principles guiding the mapping and ablation of epicardial VTs are similar to those used for endocardial VTs, but the biophysics of energy delivery may be different. Complications of the epicardial approach are also different from those of endocardial ablation, and specific precautions have to be taken to protect the coronary arteries and phrenic nerves and to avoid pericardial tamponade.
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Hasan Garan (2013) studied Epicardial ventricular tachycardia. This document is a copyright transfer and author contribution form and contains no clinical study data.
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