Epicardial ventricular tachycardia in ischemic cardiomyopathy: Prevalence, electrophysiological characteristics, and long-term ablation outcomes

Journal of Cardiovascular Electrophysiology
Tatsuya HayashiPasquale Santangeli

Abstract

The characteristics of the epicardial (EPI) substrate responsible for ventricular tachycardia (VT) in ischemic cardiomyopathy (ICM) are undefined, and data on the long-term outcomes of EPI catheter ablation limited. We evaluated the prevalence, electrophysiologic features, and outcomes of catheter ablation of EPI VT in ICM. From December 2010 to June 2013, a total of 13 of 93 (14%) patients with ICM underwent catheter ablation at our institution and had conclusive evidence of critical EPI substrate demonstrated to participate in VT with activation, entrainment and/or pace mapping during sinus rhythm (two other patients underwent EPI mapping but had no optimal ablation targets). The electrophysiologic substrate characteristics and activation/entrainment mapping data were compared with a reference group of ICM patients without evidence of critical EPI substrate (N = 44), defined as a complete procedural success (noninducibility of any VT at programmed stimulation) after endocardial (ENDO)-only ablation. Patients with failed EPI access (N = 2) or history of cardiac surgery (N = 92) were excluded from the study. All 13 patients had evidence of abnormal EPI substrate with fractionated/late/split electrograms and low-bipolar voltage ...Continue Reading

References

May 1, 1997·Journal of the American College of Cardiology·W G StevensonH Khan
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Frank BogunFred Morady
May 30, 2007·Circulation·William G Stevenson, Kyoko Soejima
Nov 23, 2007·Journal of Cardiovascular Electrophysiology·Karen P PhillipsRobert A Schweikert
Mar 24, 2009·Journal of Cardiovascular Electrophysiology·Haris M HaqqaniJonathan M Kalman
Dec 17, 2009·Circulation. Arrhythmia and Electrophysiology·Ermengol VallèsFrancis E Marchlinski
May 22, 2010·Journal of the American College of Cardiology·Frédéric SacherWilliam G Stevenson
Apr 3, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Yasuhiro YoshigaFeifan Ouyang
Dec 19, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Roderick TungKalyanam Shivkumar
Apr 2, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Saurabh KumarWilliam G Stevenson
Jan 1, 2016·Journal of the American College of Cardiology·Luigi Di BiaseAndrea Natale
Feb 13, 2016·Journal of the American College of Cardiology·Francis E MarchlinskiAnil K Bhandari

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Citations

Dec 18, 2018·Journal of Cardiovascular Electrophysiology·Jason S Bradfield
Jul 16, 2019·Journal of the Chinese Medical Association : JCMA·Ting-Yung ChangShih-Ann Chen

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