Key result
Percutaneous epicardial access for ventricular arrhythmia ablation poses an under-reported risk of LITA injury.
Why the study?
Injury to the left internal thoracic artery is a potential complication of epicardial needle trajectory during ablation for ventricular arrhythmias, but it remains under-reported in the literature.
Highlights the risk, prevention, and management of left internal thoracic artery injury during epicardial access for catheter ablation.
Answers are grounded in this paper and cite their sources.
Raises awareness for procedural caution during epicardial access; leaves open true incidence and optimal prevention strategies.
Since the first report of successful epicardial ablation in the late 1990s from Sosa et al,1 it has become a vital treatment option for ventricular arrhythmias.2,3 However, despite its efficacy, this technique also has risks, including potential complications related to epicardial needle trajectory.3,4 One complication involves injury to the left internal thoracic artery (LITA), which typically courses approximately 1 cm from the sternal margin and bifurcates around the sixth intercostal space. Although this potential complication has been recognized,5 it remains under-reported in the literature, with only a limited number of documented cases.
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Morishima et al. (2024) conducted a review in Ventricular arrhythmias. Percutaneous epicardial access for catheter ablation was evaluated on Left internal thoracic artery (LITA) injury. Left internal thoracic artery injury is a recognized but under-reported complication of percutaneous epicardial access for catheter ablation of ventricular arrhythmias.
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