Arrhythmias & electrophysiologyResearch article
Patient-Tailored Minimally Invasive Hybrid Ablation of Complex Ventricular Tachycardia Substrates
- retrospectively analyzed consecutive patients
- single tertiary center
- 2014-2025
- multidisciplinary preprocedural evaluation (VT-TRACT care pathway from 2022 onward)
Authors' conclusion
Minimally invasive, patient-tailored hybrid VT ablation-guided by multidisciplinary planning-achieves marked reductions in VT burden and ICD shocks with a favorable safety profile, even in complex post-surgical patients.
Study context
- Population
- Patients undergoing minimally invasive hybrid ventricular tachycardia (VT) ablation for complex substrates (86% men, median age 70 years, median PAINESD score 13, 68% VT storm)patients who underwent minimally invasive hybrid VT ablation · left- or right-sided video-assisted thoracoscopic 13 vs 1 · subxiphoid access 3 · double access 2 · anterolateral minithoracotomy 3
- Participants
- 22 patients
Main finding
As reported in the abstract
VT burden · 1 year
median VT burden before
16.5 (Q1-Q3: 9.5-37.0)
median VT burden at 1 year
0 (Q1-Q3: 0-5.8)
change
−81%
P
P < 0.001
Further findings
ICD shocks · 1 year
- ICD shocks before
- 2 (Q1-Q3: 0-5)
- ICD shocks at 1 year
- 0 (Q1-Q3: 0-0)
- change
- −90%
- P
- P < 0.001
Survival · 1 year
- One-year survival
- 82%
Indications
- prior cardiac surgery
- 7 (32%)
- extensive scar
- 3 (14%)
- concomitant left-sided sympathectomy
- 2 (9%)
- hybrid atrial fibrillation ablation
- 1 (5%)
- failed epicardial access
- 2 (9%)
- pericarditis/tamponade
- 2 (9%)
- ablation under direct visualization by preference
- 5 (23%)
Procedural characteristics
- Pericardial adhesions (bluntly dissected)
- 45%
- Mean procedure time
- 312 ± 98 minutes
Safety
Major complications
- Hemothorax requiring reoperation
- One
- no other major complications occurred
Original publication
Patient-Tailored Minimally Invasive Hybrid Ablation of Complex Ventricular Tachycardia Substrates. JACC Clin Electrophysiol. Published 8 April 2026. doi:10.1016/j.jacep.2026.02.031
Summarised from the published abstract; every number is checked against it