Arrhythmias & electrophysiology
Feasibility of carbon dioxide insufflation and impact on epicardial approach utilization for ventricular tachycardia ablation in a midvolume referral center
Authors' conclusion
In our single-center experience, EpiCO2 was feasible and safe and led to significant increase in procedural volume without affecting total procedural time compared with standard dry puncture.
Study context
- Population
- Consecutive patients undergoing epicardial ventricular tachycardia (VT) ablation at a referral centre (Pisa University Hospital), November 2022–January 2024
- Participants
- 22 vs 20
- Exposure
- EpiCO2 vs subxiphoid dry puncture for epicardial access
- EpiCO2n = 22
- Dry puncturen = 20reference
- Outcome
- Procedural feasibility, safety and impact of EpiCO2 on epicardial access
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Median time from coronary sinus (CS) cannulation to epicardial access
33 minutes
CO2 insufflation not feasible
1 patient
Epicardial approach utilisation, before vs since EpiCO2 introduction (% of all VT procedures)
17.8% to 40%
Observational data: associations, not effects.
Further findings
Total procedural duration, EpiCO2 vs standard dry approach epicardial ablation (retrospective cohort)
- No significant difference in total procedural duration (EpiCO2 vs dry approach), minutes, median [IQR]
- 322.5 [296.75-363.75] vs 359 [323-409]; P = .08
- 20 standard dry approach epicardial ablations as comparator
Epicardial approach utilization (% of all VT procedures)
- Increased since EpiCO2 introduction
- 17.8% to 40%
Safety
Major complications and significant bleeding (EpiCO2)
- Major complications
- 0
- Significant bleeding
- 0
Original publication
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