Epicardial ventricular tachycardia ablation a multicenter safety study
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Epicardial ventricular tachycardia ablation a multicenter safety study. / Sacher, Frédéric; Roberts-Thomson, Kurt; Maury, Philippe; Tedrow, Usha; Nault, Isabelle; Steven, Daniel; Hocini, Meleze; Koplan, Bruce; Leroux, Lionel; Derval, Nicolas; Seiler, Jens; Wright, Matthew J; Epstein, Laurence; Haissaguerre, Michel; Jais, Pierre; Stevenson, William G.
in: J AM COLL CARDIOL, Jahrgang 55, Nr. 21, 25.05.2010, S. 2366-2372.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Epicardial ventricular tachycardia ablation a multicenter safety study
AU - Sacher, Frédéric
AU - Roberts-Thomson, Kurt
AU - Maury, Philippe
AU - Tedrow, Usha
AU - Nault, Isabelle
AU - Steven, Daniel
AU - Hocini, Meleze
AU - Koplan, Bruce
AU - Leroux, Lionel
AU - Derval, Nicolas
AU - Seiler, Jens
AU - Wright, Matthew J
AU - Epstein, Laurence
AU - Haissaguerre, Michel
AU - Jais, Pierre
AU - Stevenson, William G
N1 - Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2010/5/25
Y1 - 2010/5/25
N2 - OBJECTIVES: The aim of this study was to perform a systematic evaluation of safety and midterm complications after epicardial ventricular tachycardia (VT) ablation.BACKGROUND: Epicardial VT ablation is increasingly performed, but there is limited information about its safety and midterm complications.METHODS: All patients undergoing VT ablation at 3 tertiary care centers between 2001 and 2007 were included in this study. Of 913 VT ablations, 156 procedures (17%) involved epicardial mapping and/or ablation. These were performed in 134 patients (109 men; mean age 56 +/- 15 years) after a previous VT ablation in 115 (86%). The underlying substrates were ischemic cardiomyopathy in 51 patients, nonischemic cardiomyopathy in 39 patients, arrhythmogenic right ventricular cardiomyopathy in 14 patients, and other types of cardiomyopathy in 30 patients.RESULTS: Epicardial access was obtained via percutaneous subxiphoid puncture in 136 procedures, by a surgical subxiphoid approach in 14, and during open-heart surgery in 6. Epicardial ablation (mean radiofrequency duration: 13 +/- 12 min; median: 10 min) was performed in 121 of 156 procedures (78%). Twenty patients subsequently required repeat procedures, and the epicardium could be reaccessed in all but 1 patient. A total of 8 (5%) major complications related to pericardial access were observed acutely: 7 epicardial bleeding (>80 cm(3)) and 1 coronary stenosis. After a mean follow-up period of 23 +/- 21 months, 3 delayed complications related to pericardial access were noted: 1 major pericardial inflammatory reaction, 1 delayed tamponade, and 1 coronary occlusion 2 weeks after the procedure.CONCLUSIONS: VT ablation required epicardial ablation in 121 of 913 procedures (13%), with a risk of 5% and 2% of acute and delayed major complications related to epicardial access.
AB - OBJECTIVES: The aim of this study was to perform a systematic evaluation of safety and midterm complications after epicardial ventricular tachycardia (VT) ablation.BACKGROUND: Epicardial VT ablation is increasingly performed, but there is limited information about its safety and midterm complications.METHODS: All patients undergoing VT ablation at 3 tertiary care centers between 2001 and 2007 were included in this study. Of 913 VT ablations, 156 procedures (17%) involved epicardial mapping and/or ablation. These were performed in 134 patients (109 men; mean age 56 +/- 15 years) after a previous VT ablation in 115 (86%). The underlying substrates were ischemic cardiomyopathy in 51 patients, nonischemic cardiomyopathy in 39 patients, arrhythmogenic right ventricular cardiomyopathy in 14 patients, and other types of cardiomyopathy in 30 patients.RESULTS: Epicardial access was obtained via percutaneous subxiphoid puncture in 136 procedures, by a surgical subxiphoid approach in 14, and during open-heart surgery in 6. Epicardial ablation (mean radiofrequency duration: 13 +/- 12 min; median: 10 min) was performed in 121 of 156 procedures (78%). Twenty patients subsequently required repeat procedures, and the epicardium could be reaccessed in all but 1 patient. A total of 8 (5%) major complications related to pericardial access were observed acutely: 7 epicardial bleeding (>80 cm(3)) and 1 coronary stenosis. After a mean follow-up period of 23 +/- 21 months, 3 delayed complications related to pericardial access were noted: 1 major pericardial inflammatory reaction, 1 delayed tamponade, and 1 coronary occlusion 2 weeks after the procedure.CONCLUSIONS: VT ablation required epicardial ablation in 121 of 913 procedures (13%), with a risk of 5% and 2% of acute and delayed major complications related to epicardial access.
KW - Adult
KW - Aged
KW - Arrhythmogenic Right Ventricular Dysplasia/complications
KW - Catheter Ablation/adverse effects
KW - Cohort Studies
KW - Electrocardiography
KW - Epicardial Mapping/methods
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Myocardial Ischemia/complications
KW - Postoperative Complications/etiology
KW - Prognosis
KW - Reoperation
KW - Retrospective Studies
KW - Risk Assessment
KW - Safety Management
KW - Severity of Illness Index
KW - Survival Rate
KW - Tachycardia, Ventricular/complications
KW - Treatment Outcome
U2 - 10.1016/j.jacc.2009.10.084
DO - 10.1016/j.jacc.2009.10.084
M3 - SCORING: Journal article
C2 - 20488308
VL - 55
SP - 2366
EP - 2372
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 21
ER -
