Hybrid procedures for epicardial catheter ablation of ventricular tachycardia: value of surgical access

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Yoav MichowitzKalyanam Shivkumar

Abstract

Prior chest surgery limits the ability to obtain epicardial access in patients referred for catheter ablation of ventricular tachycardia (VT). The purpose of this study was to describe the utility of different surgical approaches to access the epicardium for VT ablation. Clinical data of 14 patients with drug-refractory VT who underwent hybrid surgical epicardial access for catheter mapping and ablation in the electrophysiology lab were reviewed. Baseline patient and procedural characteristics including access, exposure, mapping techniques, and ablation were analyzed. Of a total of 14 patients (age 63.2 ± 10.3 years), 11 had a subxiphoid window performed, and three patients underwent limited anterior thoracotomy to access the epicardium. The indication for surgical access was prior cardiac surgery (n = 12), previous failed epicardial access (n = 1), and ablation in close proximity to the coronary arteries and phrenic nerve (n = 1). Mapping in patients with subxiphoid surgical access was limited to the inferior and diaphragmatic surface of the heart extending posteriorly to the basal lateral wall. With limited anterior thoracotomy, access to the apex, anterior, and mid to apical anterolateral walls was obtained. In these regions...Continue Reading

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Citations

Jun 2, 2011·Future Cardiology·Tara BourkeKalyanam Shivkumar
May 30, 2012·Nature Reviews. Cardiology·Takumi Yamada, G Neal Kay
Feb 27, 2014·Indian Heart Journal·Olujimi A AjijolaKalyanam Shivkumar
Dec 19, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Roderick TungKalyanam Shivkumar
May 31, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Aman Mahajan, Jason Chua
Apr 5, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jacob S Koruth, Andre d'Avila
Oct 7, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Ricky YuNoel G Boyle
Dec 9, 2015·Journal of Cardiovascular Electrophysiology·Hygriv B RaoJason S Bradfield
Aug 26, 2015·Methodist DeBakey Cardiovascular Journal·Roderick Tung, Kalyanam Shivkumar
Oct 31, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Thomas Deneke, Andreas Mügge
Jan 19, 2013·JACC. Cardiovascular Imaging·Roderick Tung, Kalyanam Shivkumar
Mar 20, 2015·Anesthesia and Analgesia·Alexander J C MittnachtAman Mahajan
Feb 16, 2012·Circulation. Arrhythmia and Electrophysiology·Roderick TungKalyanam Shivkumar
Dec 29, 2011·Circulation. Arrhythmia and Electrophysiology·Nilesh S MathuriaKalyanam Shivkumar
Oct 14, 2016·Circulation. Arrhythmia and Electrophysiology·Guo JincunRoderick Tung
May 25, 2011·Circulation·Roderick TungKalyanam Shivkumar
Oct 3, 2012·Circulation·Noel G Boyle, Kalyanam Shivkumar
Apr 18, 2019·The New England Journal of Medicine·Kalyanam Shivkumar
May 3, 2019·Journal of Investigative Medicine High Impact Case Reports·Gabriel E Soto, Joseph G Gibbons
May 11, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Edmond M CroninUNKNOWN ESC Scientific Document Group
Jul 27, 2017·Pacing and Clinical Electrophysiology : PACE·Shailendra UpadhyayJ Philip Saul
May 28, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Peng-Pai ZhangFeifan Ouyang
Dec 18, 2019·Korean Circulation Journal·Ashwin BhaskaranSaurabh Kumar
Jan 28, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Edmond M CroninKatja Zeppenfeld
Sep 29, 2020·HeartRhythm Case Reports·Vickram Vignesh RangaswamyCalambur Narasimhan
Jul 15, 2021·Journal of Cardiovascular Electrophysiology·Gang YangMinglong Chen
Aug 19, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Angeliki DarmaArash Arya

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