Interv Akut Kardiol. 2010;9(1):16-19

Epicardial ablation of ventricular tachycardias

Josef Kautzner, Petr Peichl

Klinika kardiologie, Institut klinické a experimentální medicíny, Praha

Catheter ablation of ventricular tachycardias (VTs) has undergone enormous development in the last decade. The advent of electroanatomic

mapping has lead to improvement of efficacy of some focal arrhythmias and enabled the so-called substrate mapping of VTs

in the presence of structural heart disease. Nevertheless, some VTs have critical part of the substrate localized epicardially. Epicardial

mapping can be performed after pericardial puncture using epidural needle and introduction of a special sheath. Using this approach,

entire surface of both ventricles can be mapped epicardially and catheter ablation performed, either by radiofrequency current or by

cryoprobe. This strategy is indicated especially in cases when at least one endocardial approach has failed or cannot be performed.

Epicardial location of the arrhythmogenic substrate can be expected in patients with VT in dilated cardiomyopathy or arrhythmogenic

dysplasia of the right ventricle.

Keywords: ventricular tachycardia, catheter ablation, electroanatomic mapping, epicardial ablation

Published: March 1, 2010  Show citation