Arrhythmias & electrophysiology
Road-Map to Epicardial Approach for Catheter Ablation of Ventricular Tachycardia in Structural Heart Disease: Results From a 10-Year Tertiary-Center Experience
Authors' conclusion
Epicardial approach is integral part of ablation armamentarium regardless of the VT cause, with high feasibility and low complication rate in experienced centers.
Study context
- Population
- Patients with structural heart disease undergoing ventricular tachycardia (VT) ablation including epicardial approach626 epicardial VT ablations
- Participants
- 488 patients
- Exposure
- Epicardial approach for VT ablation across VT causes
- Outcome
- Epicardial ablation performed after epicardial mapping (useful epicardial approach) vs unnecessary pericardial access
Methodological detailssingle tertiary centre, 10-year experience
- Single tertiary centre
- 10-year experience
Main finding
As reported in the abstract
Epicardial ablation at first ablation attempt
Odds ratio (95% CI)P value
ARVCodds for epicardial ablation, first-line epicardial group
4.057(1.299–8.937)
P = 0.007Myocarditisodds for epicardial ablation, first-line epicardial group
3.971(1.376–11.465)
P = 0.005IDCMindependent predictor of unnecessary epicardial approach
2.7(1.7–4.3)
P < 0.001Observational data: associations, not effects.
Further findings
Percutaneous access success
- Success rate
- 92.2%
Recurrences and mortality · follow-up 41 months (IQR 19-64)
- Idiopathic dilated cardiomyopathy (IDCM) had higher rate of recurrences and mortality vs other causes
Safety
Complications of percutaneous access
- Complication rate
- 3.6%
Original publication
Road-Map to Epicardial Approach for Catheter Ablation of Ventricular Tachycardia in Structural Heart Disease: Results From a 10-Year Tertiary-Center Experience. Circ Arrhythm Electrophysiol. Published 5 June 2024. doi:10.
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