Epicardial ablation for ventricular tachycardia: A European multicenter study

Paolo Della Bella, Josep Brugada, Katja Zeppenfeld, Jose Merino, Petr Neuzil, Philippe Maury, Giuseppe MacCabelli, Pasquale Vergara, Francesca Baratto, Antonio Berruezo, Adrianus P. Wijnmaalen

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Abstract

Background-The purpose of this study was to describe the epicardial percutaneous ablation experience of 6 European high-volume ventricular tachycardia (VT) ablation centers. Methods and Results-Data from 218 patients with coronary artery disease (CAD, n=85 [39.0%]), idiopathic dilated of patients with idiopathic VT cardiomyopathy (IDCM, n=67 [30.7%]), arrhythmogenic right ventricular dysplasia/ cardiomyopathy (ARCD/C, n=13 [6%]), hypertrophic cardiomyopathy (HCM, n=5 [2.3%]), and absence of structural heart disease (n=48 [22%]) undergoing epicardial subxyphoid access for VT ablation were collected. The epicardial approach was attempted as first-line treatment in 78 patients (35.8%). Acute prevention of VT inducibility was obtained in 156 patients (71.6%). There were no procedure-related deaths. Cardiac tamponade occurred in 8 patients, and abdominal hemorrhage in 1 patient. Six patients died of electrical storm recurrence within 48 hours from the procedure. After a mean follow-up of 17.3±18.2 months, 60 patients (31.4%) presented with VT recurrence (39.3% of IDCM patients; 34.7% of CAD patients; 30.8% of ARVD/C patients; 25% of HCM patients; 17.1% of patients with idiopathic VT). Twenty patients (10.4%) died during follow-up (12 of heart failure, 2 of cardiac arrest, and 6 of extracardiac causes). Conclusions-In experienced centers, epicardial ablation of VT has an acceptable risk and favorable outcome. In selected patients, it is reasonable to consider as a first-line ablation approach.

Original languageEnglish
Pages (from-to)653-659
Number of pages7
JournalCirculation: Arrhythmia and Electrophysiology
Volume4
Issue number5
DOIs
Publication statusPublished - Oct 2011

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Keywords

  • Percutaneous epicardial mapping
  • Radiofrequency catheter ablation
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Bella, P. D., Brugada, J., Zeppenfeld, K., Merino, J., Neuzil, P., Maury, P., MacCabelli, G., Vergara, P., Baratto, F., Berruezo, A., & Wijnmaalen, A. P. (2011). Epicardial ablation for ventricular tachycardia: A European multicenter study. Circulation: Arrhythmia and Electrophysiology, 4(5), 653-659. https://doi.org/10.1161/CIRCEP.111.962217