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Necessity of epicardial ablation for ventricular tachycardia after sequential endocardial approach

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Necessity of epicardial ablation for ventricular tachycardia after sequential endocardial approach. / Sultan, Arian; Lüker, Jakob; Hoffmann, Boris; Servatius, Helge; Aydin, Ali; Nührich, Jana; Akbulak, Özge; Schreiber, Doreen; Schäffer, Benjamin; Rostock, Thomas; Willems, Stephan; Steven, Daniel.

In: INT J CARDIOL, Vol. 182, 01.03.2015, p. 56-61.

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

Harvard

Sultan, A, Lüker, J, Hoffmann, B, Servatius, H, Aydin, A, Nührich, J, Akbulak, Ö, Schreiber, D, Schäffer, B, Rostock, T, Willems, S & Steven, D 2015, 'Necessity of epicardial ablation for ventricular tachycardia after sequential endocardial approach', INT J CARDIOL, vol. 182, pp. 56-61. https://doi.org/10.1016/j.ijcard.2014.12.003

APA

Sultan, A., Lüker, J., Hoffmann, B., Servatius, H., Aydin, A., Nührich, J., Akbulak, Ö., Schreiber, D., Schäffer, B., Rostock, T., Willems, S., & Steven, D. (2015). Necessity of epicardial ablation for ventricular tachycardia after sequential endocardial approach. INT J CARDIOL, 182, 56-61. https://doi.org/10.1016/j.ijcard.2014.12.003

Vancouver

Sultan A, Lüker J, Hoffmann B, Servatius H, Aydin A, Nührich J et al. Necessity of epicardial ablation for ventricular tachycardia after sequential endocardial approach. INT J CARDIOL. 2015 Mar 1;182:56-61. https://doi.org/10.1016/j.ijcard.2014.12.003

Bibtex

@article{4f1213c7f1344866972f3c4fd48751f5,
title = "Necessity of epicardial ablation for ventricular tachycardia after sequential endocardial approach",
abstract = "BACKGROUND: Catheter ablation (CA) of ventricular tachycardia (VT) is an important treatment option in patients with structural heart disease (SHD) and implantable cardioverter defibrillator (ICD). A subset of patients requires epicardial CA for VT.OBJECTIVE: The purpose of the study was to assess the significance of epicardial CA in these patients after a systematic sequential endocardial approach.METHODS: Between January 2009 and October 2012 CA for VT was analyzed. A sequential CA approach guided by earliest ventricular activation, pacemap, entrainment and stimulus to QRS-interval analysis was used. Acute CA success was assessed by programmed ventricular stimulation. ICD interrogation and 24h-Holter ECG were used to evaluate long-term success.RESULTS: One hundred sixty VT ablation procedures in 126 consecutive patients (114 men; age 65±12years) were performed. Endocardial CA succeeded in 250 (94%) out of 265 treated VT. For 15 (6%) VT an additional epicardial CA was performed and succeeded in 9 of these 15 VT. Long-term FU (25±18.2month) showed freedom of VT in 104 pts (82%) after 1.2±0.5 procedures, 11 (9%) suffered from repeated ICD shocks and 11 (9%) died due to worsening of heart failure.CONCLUSIONS: Despite a heterogenic substrate for VT in SHD, endocardial CA alone results in high acute success rates. In this study additional epicardial CA following a sequential endocardial mapping and CA approach was performed in 6% of VT. Thus, due to possible complications epicardial CA should only be considered if endocardial CA fails.",
keywords = "Aged, Catheter Ablation/methods, Endocardium/surgery, Female, Follow-Up Studies, Heart Conduction System/physiopathology, Heart Rate/physiology, Humans, Male, Pericardium/surgery, Recurrence, Reoperation, Retrospective Studies, Tachycardia, Ventricular/physiopathology, Treatment Outcome",
author = "Arian Sultan and Jakob L{\"u}ker and Boris Hoffmann and Helge Servatius and Ali Aydin and Jana N{\"u}hrich and {\"O}zge Akbulak and Doreen Schreiber and Benjamin Sch{\"a}ffer and Thomas Rostock and Stephan Willems and Daniel Steven",
note = "Copyright {\textcopyright} 2014 Elsevier Ireland Ltd. All rights reserved.",
year = "2015",
month = mar,
day = "1",
doi = "10.1016/j.ijcard.2014.12.003",
language = "English",
volume = "182",
pages = "56--61",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - Necessity of epicardial ablation for ventricular tachycardia after sequential endocardial approach

AU - Sultan, Arian

AU - Lüker, Jakob

AU - Hoffmann, Boris

AU - Servatius, Helge

AU - Aydin, Ali

AU - Nührich, Jana

AU - Akbulak, Özge

AU - Schreiber, Doreen

AU - Schäffer, Benjamin

AU - Rostock, Thomas

AU - Willems, Stephan

AU - Steven, Daniel

N1 - Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - BACKGROUND: Catheter ablation (CA) of ventricular tachycardia (VT) is an important treatment option in patients with structural heart disease (SHD) and implantable cardioverter defibrillator (ICD). A subset of patients requires epicardial CA for VT.OBJECTIVE: The purpose of the study was to assess the significance of epicardial CA in these patients after a systematic sequential endocardial approach.METHODS: Between January 2009 and October 2012 CA for VT was analyzed. A sequential CA approach guided by earliest ventricular activation, pacemap, entrainment and stimulus to QRS-interval analysis was used. Acute CA success was assessed by programmed ventricular stimulation. ICD interrogation and 24h-Holter ECG were used to evaluate long-term success.RESULTS: One hundred sixty VT ablation procedures in 126 consecutive patients (114 men; age 65±12years) were performed. Endocardial CA succeeded in 250 (94%) out of 265 treated VT. For 15 (6%) VT an additional epicardial CA was performed and succeeded in 9 of these 15 VT. Long-term FU (25±18.2month) showed freedom of VT in 104 pts (82%) after 1.2±0.5 procedures, 11 (9%) suffered from repeated ICD shocks and 11 (9%) died due to worsening of heart failure.CONCLUSIONS: Despite a heterogenic substrate for VT in SHD, endocardial CA alone results in high acute success rates. In this study additional epicardial CA following a sequential endocardial mapping and CA approach was performed in 6% of VT. Thus, due to possible complications epicardial CA should only be considered if endocardial CA fails.

AB - BACKGROUND: Catheter ablation (CA) of ventricular tachycardia (VT) is an important treatment option in patients with structural heart disease (SHD) and implantable cardioverter defibrillator (ICD). A subset of patients requires epicardial CA for VT.OBJECTIVE: The purpose of the study was to assess the significance of epicardial CA in these patients after a systematic sequential endocardial approach.METHODS: Between January 2009 and October 2012 CA for VT was analyzed. A sequential CA approach guided by earliest ventricular activation, pacemap, entrainment and stimulus to QRS-interval analysis was used. Acute CA success was assessed by programmed ventricular stimulation. ICD interrogation and 24h-Holter ECG were used to evaluate long-term success.RESULTS: One hundred sixty VT ablation procedures in 126 consecutive patients (114 men; age 65±12years) were performed. Endocardial CA succeeded in 250 (94%) out of 265 treated VT. For 15 (6%) VT an additional epicardial CA was performed and succeeded in 9 of these 15 VT. Long-term FU (25±18.2month) showed freedom of VT in 104 pts (82%) after 1.2±0.5 procedures, 11 (9%) suffered from repeated ICD shocks and 11 (9%) died due to worsening of heart failure.CONCLUSIONS: Despite a heterogenic substrate for VT in SHD, endocardial CA alone results in high acute success rates. In this study additional epicardial CA following a sequential endocardial mapping and CA approach was performed in 6% of VT. Thus, due to possible complications epicardial CA should only be considered if endocardial CA fails.

KW - Aged

KW - Catheter Ablation/methods

KW - Endocardium/surgery

KW - Female

KW - Follow-Up Studies

KW - Heart Conduction System/physiopathology

KW - Heart Rate/physiology

KW - Humans

KW - Male

KW - Pericardium/surgery

KW - Recurrence

KW - Reoperation

KW - Retrospective Studies

KW - Tachycardia, Ventricular/physiopathology

KW - Treatment Outcome

U2 - 10.1016/j.ijcard.2014.12.003

DO - 10.1016/j.ijcard.2014.12.003

M3 - SCORING: Journal article

C2 - 25576719

VL - 182

SP - 56

EP - 61

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

ER -