Epicardial ventricular tachycardia ablation a multicenter safety study.
Frédéric Sacher1, Kurt Roberts-Thomson, Philippe Maury
1Université Bordeaux II, Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France. frederic.sacher@chu-bordeaux.fr
Journal of the American College of Cardiology
|May 22, 2010
Summary
Epicardial ablation for ventricular tachycardia (VT) is common, with a 5% acute and 2% delayed major complication risk related to epicardial access. This study evaluates safety and midterm outcomes of this procedure.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Surgery
Background:
- Epicardial ventricular tachycardia (VT) ablation is increasingly utilized.
- Limited data exists on the safety and midterm complications of epicardial VT ablation.
Purpose of the Study:
- To systematically evaluate the safety and midterm complications of epicardial VT ablation.
Main Methods:
- Retrospective analysis of 913 VT ablations across 3 centers (2001-2007).
- Focused on 156 procedures (17%) involving epicardial mapping/ablation in 134 patients.
- Detailed analysis of epicardial access methods, ablation parameters, and complication rates.
Main Results:
- Epicardial access was achieved via percutaneous subxiphoid puncture in most cases.
- Major acute complications (5%) included epicardial bleeding and coronary stenosis.
- Delayed complications (2%) involved pericardial inflammation, tamponade, and coronary occlusion.
Conclusions:
- Epicardial ablation was performed in 13% of VT ablation procedures.
- The risk of acute and delayed major complications related to epicardial access is 5% and 2%, respectively.
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