Epicardial ablation of ventricular tachycardia using pericardioscopy through submammary minimal thoracotomy

The subxiphoid access became the standard technique for epicardial ablation of ventricular tachycardia. However, it may prove difficult in certain situations. Here, we report an alternative method of epicardial and endocardial ablation performed via submammary minimal thoracotomy guided by pericardioscopy. Two male patients with structural heart disease and incessant ventricular tachycardia were successfully ablated using this technique. The described technique can be considered as an alternative to the standard technique. Moreover, it permits real-time visualization of cardiac vessels and fat tissue, and is safe in terms of damage to the phrenic nerve or potential bleeding complications.