Clin Res Cardiol 101, Suppl 1, April 2012

V101 - Safety and feasibility of Epicardial VT Ablation
S. Mathew1, A. Fürnkranz2, A. Metzner1, A. Rillig1, R. R. Tilz1, E. Wißner1, K.-H. Kuck1, F. Ouyang1
1II. Medizinische Abteilung, Fachabt. Kardiologie, Asklepios Klinik St. Georg, Hanseatisches Herzzentrum Hamburg, Hamburg; 2Kardiologie, AK St. Georg, Hamburg;
Introduction: Epicardial VT Ablation is required in different types of Ventricular Tachycardias, but there is still limited information about its safety. In the current study we sought to determine the feasibility and safety of Epicardial VT Ablation.
Methods: Between 2003 and 2010 665 VT- Ablations were performed.  In 11,5% (77/665) of these ablations an epicardial approach (mapping or ablation) was required. Epicardial access was obtained via percutaneous subxiphoid puncture in all patients followed by epicardial mapping and ablation. 
Results: In 61 patients (46 male; mean age 51 ± 16 years) an epicardial approach was performed. The underlying heart disease were ischemic cardiomyopathy in 10, dilatative cardiomyopathy in 20, arrhythmogenic right ventricular dysplasia in 13 and miscellaneous types of cardiomyopathies in 18 patients (pts). In 15/61 pts (24,6%) repeat epicardial procedures were required. Out of these in 6 patients an epicardial procedure was not possible due to adhesions.
Pericardial effusion (293 ± 137ml) was presented in 5/77 (6,5%) epicardial procedures. Two patients underwent surgical treatment due to RV perforation and accidental insertion of the pericardial sheeth via the liver. In one patient a none fatal pulmonary embolism occurred. Five patients showed symptoms of sterile pericarditis. No coronary occlusions or stenosis were observed.
Conclusions: Epicardial approach was required in 11,5% of all VT Ablations. Repeat epicardial access increases the risk of adhesions. The incidence of major complications is not to neglect.
Clin Res Cardiol 101, Suppl 1, April 2012
Zitierung mit Vortrags- oder Posternummer s.o.
DOI 10.1007/s00392-012-1100-6