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.
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.
Authors: Edmond M Cronin; Frank M Bogun; Philippe Maury; Petr Peichl; Minglong Chen; Narayanan Namboodiri; Luis Aguinaga; Luiz Roberto Leite; Sana M Al-Khatib; Elad Anter; Antonio Berruezo; David J Callans; Mina K Chung; Phillip Cuculich; Andre d'Avila; Barbara J Deal; Paolo Della Bella; Thomas Deneke; Timm-Michael Dickfeld; Claudio Hadid; Haris M Haqqani; G Neal Kay; Rakesh Latchamsetty; Francis Marchlinski; John M Miller; Akihiko Nogami; Akash R Patel; Rajeev Kumar Pathak; Luis C Saenz Morales; Pasquale Santangeli; John L Sapp; Andrea Sarkozy; Kyoko Soejima; William G Stevenson; Usha B Tedrow; Wendy S Tzou; Niraj Varma; Katja Zeppenfeld Journal: J Interv Card Electrophysiol Date: 2020-10 Impact factor: 1.900
Authors: Pasquale Vergara; Wendy S Tzou; Roderick Tung; Chiara Brombin; Alessandro Nonis; Marmar Vaseghi; David S Frankel; Luigi Di Biase; Usha Tedrow; Nilesh Mathuria; Shiro Nakahara; Venkat Tholakanahalli; T Jared Bunch; J Peter Weiss; Timm Dickfeld; Dhanunjaya Lakireddy; J David Burkhardt; Pasquale Santangeli; David Callans; Andrea Natale; Francis Marchlinski; William G Stevenson; Kalyanam Shivkumar; William H Sauer; Paolo Della Bella Journal: Circ Arrhythm Electrophysiol Date: 2018-12
Authors: Marmar Vaseghi; Tiffany Y Hu; Roderick Tung; Pasquale Vergara; David S Frankel; Luigi Di Biase; Usha B Tedrow; Jeffrey A Gornbein; Ricky Yu; Nilesh Mathuria; Shiro Nakahara; Wendy S Tzou; William H Sauer; J David Burkhardt; Venkatakrishna N Tholakanahalli; Timm-Michael Dickfeld; J Peter Weiss; T Jared Bunch; Madhu Reddy; David J Callans; Dhanunjaya R Lakkireddy; Andrea Natale; Francis E Marchlinski; William G Stevenson; Paolo Della Bella; Kalyanam Shivkumar Journal: JACC Clin Electrophysiol Date: 2018-07-25
Authors: Ammar M Killu; Alan M Sugrue; Siva K Mulpuru; Christopher J McLeod; David O Hodge; Peter A Noseworthy; Lisa Fanning; Thomas M Munger; Douglas L Packer; Samuel J Asirvatham; Paul A Friedman Journal: J Interv Card Electrophysiol Date: 2016-05-18 Impact factor: 1.900
Authors: Toby Rogers; Kanishka Ratnayaka; William H Schenke; Anthony Z Faranesh; Jonathan R Mazal; William W O'Neill; Adam B Greenbaum; Robert J Lederman Journal: Catheter Cardiovasc Interv Date: 2014-10-28 Impact factor: 2.692
Authors: Prabhat Kumar; J Paul Mounsey; Anil K Gehi; Jennifer D Schwartz; Eugene H Chung Journal: J Interv Card Electrophysiol Date: 2013-04-19 Impact factor: 1.900