Related Experiment Video

Updated: Apr 24, 2026

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

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Determinants of recurrence after epicardial ventricular tachycardia ablation in structural heart disease

Angeliki Darma1, Said-Elias Waezsada1, Arash Arya2

  • 1Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum, Bad Oeynhausen, Germany.

Heart Rhythm
|April 22, 2026
PubMed

Insights

Recurrent ventricular tachycardia (VT) after epicardial ablation in structural heart disease (SHD) is common. Electrical storm, longer VT cycle length, and higher body mass index predict recurrence.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Epicardial catheter ablation is a key treatment for ventricular tachycardia (VT) in structural heart disease (SHD).
  • VT recurrence after ablation, especially in advanced cardiomyopathy, remains a significant clinical challenge.

Purpose of the Study:

  • To determine the clinical and electrophysiological factors predicting VT recurrence after epicardial ablation in SHD patients.
  • To assess outcomes of epicardial VT ablation in a cohort with advanced structural heart disease.

Main Methods:

  • Seventy-four patients with SHD underwent epicardial VT ablation.
  • Analysis of acute procedural outcomes, VT recurrence rates, and adverse clinical events during follow-up.
  • Cox regression analysis identified independent predictors of VT recurrence.

Main Results:

  • Non-ischemic cardiomyopathy was the most common cause of SHD.
  • Electrical storm, longer VT cycle length, and higher body mass index (BMI) were independently associated with increased VT recurrence risk.
  • VT recurrence occurred in 50% of patients during a median follow-up of 17 months, despite 66% achieving acute non-inducibility.

Conclusions:

  • Epicardial VT ablation in advanced SHD offers moderate acute success but is associated with frequent recurrence.
  • Identifying patients at higher risk for VT recurrence (e.g., those with electrical storm, longer VT cycle length, or higher BMI) is crucial for guiding management.
  • The study highlights the need for improved strategies to reduce long-term VT recurrence in this challenging patient population.
Abstract

Keywords:
Epicardial catheter ablationEpicardial fatStructural heart diseaseVT recurrenceVentricular tachycardia

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