Selecting the Appropriate Ablation Strategy: the Role of Endocardial and/or Epicardial Access

Arrhythmia & Electrophysiology Review
Mario Njeim, Frank Bogun

Abstract

Percutaneous catheter ablation has emerged as an effective treatment modality for the management of ventricular tachycardia. Despite years of progress in this field, the role of epicardial mapping and ablation needs to be further refined. In this review, we discuss the relationship between the type of underlying heart disease and the location of the arrythmogenic substrate as it pertains to a procedural approach. We describe the contribution of preprocedural and intraprocedural diagnostic tools for the localisation of the arrhythmogenic substrate, with a special emphasis on cardiac MRI and electrophysiological mapping. In our opinion, the preferred approach to target ventricular tachycardia should depend on the patient's underlying heart disease and the location of scar tissue, which can be best visualised using cardiac MRI.

Citations

Dec 28, 2018·Arrhythmia & Electrophysiology Review·Daniele MuserPasquale Santangeli
Mar 23, 2017·European Heart Journal·Thomas BartelSilvana Müller
Aug 11, 2018·Ultrasound in Medicine & Biology·Alexandre CostetElisa Konofagou

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