Percutaneous access of the epicardial space for mapping ventricular and supraventricular arrhythmias in patients with and without prior cardiac surgery
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Percutaneous access of the epicardial space for mapping ventricular and supraventricular arrhythmias in patients with and without prior cardiac surgery. / Roberts-Thomson, Kurt C; Seiler, Jens; Steven, Daniel; Inada, Keiichi; Michaud, Gregory F; John, Roy M; Koplan, Bruce A; Epstein, Laurence M; Stevenson, William G; Tedrow, Usha B.
in: J CARDIOVASC ELECTR, Jahrgang 21, Nr. 4, 04.2010, S. 406-411.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Percutaneous access of the epicardial space for mapping ventricular and supraventricular arrhythmias in patients with and without prior cardiac surgery
AU - Roberts-Thomson, Kurt C
AU - Seiler, Jens
AU - Steven, Daniel
AU - Inada, Keiichi
AU - Michaud, Gregory F
AU - John, Roy M
AU - Koplan, Bruce A
AU - Epstein, Laurence M
AU - Stevenson, William G
AU - Tedrow, Usha B
PY - 2010/4
Y1 - 2010/4
N2 - INTRODUCTION: There is a paucity of data on the success rates of achieving percutaneous epicardial access in different groups of patients.METHODS AND RESULTS: Percutaneous epicardial access was attempted in 137 patients having 149 procedures; 19 patients had supraventricular tachycardia (SVT), 25 patients had idiopathic VT and 93 patients had scar-related ventricular tachycardia (VT). Ten patients had prior cardiac surgery. Successful epicardial access was achieved in 133 of 149 (89.3%) procedures. Access was achieved in 17 of 19 (89.5%) patients with SVT, all patients with idiopathic VT, 80 of 93 (86.0%) patients with scar-related VT and in 2 (20%) patients with prior cardiac surgery. Attempted access failed in 16 patients; 8 had prior cardiac surgery and 3 had prior pericarditis. After an initial procedure, repeat access was attempted in 15 patients, 5.1 +/- 5.4 months after initial epicardial mapping and ablation. Access was successful in 13 (86.7%) and failed in 2 patients who had pericarditis after their first procedure. Only 4 patients were given intrapericardial glucocorticoid at their first epicardial procedure. Prior cardiac surgery and a history of pericarditis predicted unsuccessful access (P < 0.01). Complications (9 patients) included pericardial bleeding (80-250 mL) and intraabdominal bleeding.CONCLUSIONS: In patients without prior cardiac surgery, percutaneous epicardial access can be obtained in the majority of patients. Prior cardiac surgery precludes access in the most patients and when possible adhesions may limit catheter movement. Repeat access is possible in the majority of patients without the installation of intrapericardial glucocorticoid at the first procedure.
AB - INTRODUCTION: There is a paucity of data on the success rates of achieving percutaneous epicardial access in different groups of patients.METHODS AND RESULTS: Percutaneous epicardial access was attempted in 137 patients having 149 procedures; 19 patients had supraventricular tachycardia (SVT), 25 patients had idiopathic VT and 93 patients had scar-related ventricular tachycardia (VT). Ten patients had prior cardiac surgery. Successful epicardial access was achieved in 133 of 149 (89.3%) procedures. Access was achieved in 17 of 19 (89.5%) patients with SVT, all patients with idiopathic VT, 80 of 93 (86.0%) patients with scar-related VT and in 2 (20%) patients with prior cardiac surgery. Attempted access failed in 16 patients; 8 had prior cardiac surgery and 3 had prior pericarditis. After an initial procedure, repeat access was attempted in 15 patients, 5.1 +/- 5.4 months after initial epicardial mapping and ablation. Access was successful in 13 (86.7%) and failed in 2 patients who had pericarditis after their first procedure. Only 4 patients were given intrapericardial glucocorticoid at their first epicardial procedure. Prior cardiac surgery and a history of pericarditis predicted unsuccessful access (P < 0.01). Complications (9 patients) included pericardial bleeding (80-250 mL) and intraabdominal bleeding.CONCLUSIONS: In patients without prior cardiac surgery, percutaneous epicardial access can be obtained in the majority of patients. Prior cardiac surgery precludes access in the most patients and when possible adhesions may limit catheter movement. Repeat access is possible in the majority of patients without the installation of intrapericardial glucocorticoid at the first procedure.
KW - Body Surface Potential Mapping/methods
KW - Cardiac Surgical Procedures
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Pericardium
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Tachycardia, Supraventricular/diagnosis
U2 - 10.1111/j.1540-8167.2009.01645.x
DO - 10.1111/j.1540-8167.2009.01645.x
M3 - SCORING: Journal article
C2 - 19912446
VL - 21
SP - 406
EP - 411
JO - J CARDIOVASC ELECTR
JF - J CARDIOVASC ELECTR
SN - 1045-3873
IS - 4
ER -