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Epicardial access for VT ablation: analysis of two different puncture techniques, incidence of adhesions and complication management

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Epicardial access for VT ablation: analysis of two different puncture techniques, incidence of adhesions and complication management. / Mathew, Shibu; Feickert, Sebastian; Fink, Thomas; Rillig, Andreas; Reissmann, Bruno; Rottner, Laura; Hashiguchi, Naotaka; Wohlmuth, Peter; Maurer, Tilman; Lemes, Christine; Metzner, Andreas; Kuck, Karl-Heinz; Ouyang, Feifan.

In: CLIN RES CARDIOL, Vol. 110, No. 6, 06.2021, p. 810-821.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Mathew, S, Feickert, S, Fink, T, Rillig, A, Reissmann, B, Rottner, L, Hashiguchi, N, Wohlmuth, P, Maurer, T, Lemes, C, Metzner, A, Kuck, K-H & Ouyang, F 2021, 'Epicardial access for VT ablation: analysis of two different puncture techniques, incidence of adhesions and complication management', CLIN RES CARDIOL, vol. 110, no. 6, pp. 810-821. https://doi.org/10.1007/s00392-020-01711-z

APA

Mathew, S., Feickert, S., Fink, T., Rillig, A., Reissmann, B., Rottner, L., Hashiguchi, N., Wohlmuth, P., Maurer, T., Lemes, C., Metzner, A., Kuck, K-H., & Ouyang, F. (2021). Epicardial access for VT ablation: analysis of two different puncture techniques, incidence of adhesions and complication management. CLIN RES CARDIOL, 110(6), 810-821. https://doi.org/10.1007/s00392-020-01711-z

Vancouver

Mathew S, Feickert S, Fink T, Rillig A, Reissmann B, Rottner L et al. Epicardial access for VT ablation: analysis of two different puncture techniques, incidence of adhesions and complication management. CLIN RES CARDIOL. 2021 Jun;110(6):810-821. https://doi.org/10.1007/s00392-020-01711-z

Bibtex

@article{1e6613dfadb34fa9ba97b817eb2de86a,
title = "Epicardial access for VT ablation: analysis of two different puncture techniques, incidence of adhesions and complication management",
abstract = "INTRODUCTION: Pericardial access for ablation of ventricular arrhythmias (VA) can be gained either by an anterior-oriented or inferior-oriented epicardial puncture under fluoroscopical guidance. We retrospectively sought to assess the safety of these two puncture techniques and the incidence of epicardial adhesions and introduce our algorithm for management of pericardial tamponade.METHODS AND RESULTS: In 211 patients (61.4 ± 15.6 years, 179 males; 84.8%) 271 epicardial ablation procedures of VA were performed using either an anterior- or inferior-oriented approach for epicardial access. Puncture-related complications were systematically analyzed. Furthermore, the incidence of adhesions was evaluated during first and repeated procedures. A total of 34/271 (12.5%) major complications occurred and 23/271 (8.5%) were directly related to epicardial puncture. The incidence of puncture-related major complications in the anterior and inferior group was 4/82 (4.9%) and 19/189 (10.1%), respectively. Pericardial tamponade was the most common major complication (15/271; 5.5%). Collateral damages of adjacent structures such as liver, colon, gastric vessels and coronary arteries occurred in 6/189 (3.2%) patients and only within the inferior epicardial access group. Adhesions were documented in 19/211 (9%) patients during the first procedure and in 47.1% if patients had 2 or more procedures involving epicardial access.CONCLUSION: Anterior-oriented epicardial puncture shows an observed association to a reduced incidence of pericardial tamponades and overall puncture-related complications in epicardial ablation of VA. In cases of repeated epicardial access adhesions increase significantly and may lead to ablation failure.",
author = "Shibu Mathew and Sebastian Feickert and Thomas Fink and Andreas Rillig and Bruno Reissmann and Laura Rottner and Naotaka Hashiguchi and Peter Wohlmuth and Tilman Maurer and Christine Lemes and Andreas Metzner and Karl-Heinz Kuck and Feifan Ouyang",
year = "2021",
month = jun,
doi = "10.1007/s00392-020-01711-z",
language = "English",
volume = "110",
pages = "810--821",
journal = "CLIN RES CARDIOL",
issn = "1861-0684",
publisher = "D. Steinkopff-Verlag",
number = "6",

}

RIS

TY - JOUR

T1 - Epicardial access for VT ablation: analysis of two different puncture techniques, incidence of adhesions and complication management

AU - Mathew, Shibu

AU - Feickert, Sebastian

AU - Fink, Thomas

AU - Rillig, Andreas

AU - Reissmann, Bruno

AU - Rottner, Laura

AU - Hashiguchi, Naotaka

AU - Wohlmuth, Peter

AU - Maurer, Tilman

AU - Lemes, Christine

AU - Metzner, Andreas

AU - Kuck, Karl-Heinz

AU - Ouyang, Feifan

PY - 2021/6

Y1 - 2021/6

N2 - INTRODUCTION: Pericardial access for ablation of ventricular arrhythmias (VA) can be gained either by an anterior-oriented or inferior-oriented epicardial puncture under fluoroscopical guidance. We retrospectively sought to assess the safety of these two puncture techniques and the incidence of epicardial adhesions and introduce our algorithm for management of pericardial tamponade.METHODS AND RESULTS: In 211 patients (61.4 ± 15.6 years, 179 males; 84.8%) 271 epicardial ablation procedures of VA were performed using either an anterior- or inferior-oriented approach for epicardial access. Puncture-related complications were systematically analyzed. Furthermore, the incidence of adhesions was evaluated during first and repeated procedures. A total of 34/271 (12.5%) major complications occurred and 23/271 (8.5%) were directly related to epicardial puncture. The incidence of puncture-related major complications in the anterior and inferior group was 4/82 (4.9%) and 19/189 (10.1%), respectively. Pericardial tamponade was the most common major complication (15/271; 5.5%). Collateral damages of adjacent structures such as liver, colon, gastric vessels and coronary arteries occurred in 6/189 (3.2%) patients and only within the inferior epicardial access group. Adhesions were documented in 19/211 (9%) patients during the first procedure and in 47.1% if patients had 2 or more procedures involving epicardial access.CONCLUSION: Anterior-oriented epicardial puncture shows an observed association to a reduced incidence of pericardial tamponades and overall puncture-related complications in epicardial ablation of VA. In cases of repeated epicardial access adhesions increase significantly and may lead to ablation failure.

AB - INTRODUCTION: Pericardial access for ablation of ventricular arrhythmias (VA) can be gained either by an anterior-oriented or inferior-oriented epicardial puncture under fluoroscopical guidance. We retrospectively sought to assess the safety of these two puncture techniques and the incidence of epicardial adhesions and introduce our algorithm for management of pericardial tamponade.METHODS AND RESULTS: In 211 patients (61.4 ± 15.6 years, 179 males; 84.8%) 271 epicardial ablation procedures of VA were performed using either an anterior- or inferior-oriented approach for epicardial access. Puncture-related complications were systematically analyzed. Furthermore, the incidence of adhesions was evaluated during first and repeated procedures. A total of 34/271 (12.5%) major complications occurred and 23/271 (8.5%) were directly related to epicardial puncture. The incidence of puncture-related major complications in the anterior and inferior group was 4/82 (4.9%) and 19/189 (10.1%), respectively. Pericardial tamponade was the most common major complication (15/271; 5.5%). Collateral damages of adjacent structures such as liver, colon, gastric vessels and coronary arteries occurred in 6/189 (3.2%) patients and only within the inferior epicardial access group. Adhesions were documented in 19/211 (9%) patients during the first procedure and in 47.1% if patients had 2 or more procedures involving epicardial access.CONCLUSION: Anterior-oriented epicardial puncture shows an observed association to a reduced incidence of pericardial tamponades and overall puncture-related complications in epicardial ablation of VA. In cases of repeated epicardial access adhesions increase significantly and may lead to ablation failure.

U2 - 10.1007/s00392-020-01711-z

DO - 10.1007/s00392-020-01711-z

M3 - SCORING: Journal article

C2 - 32719917

VL - 110

SP - 810

EP - 821

JO - CLIN RES CARDIOL

JF - CLIN RES CARDIOL

SN - 1861-0684

IS - 6

ER -