Sultan, Arian, Lueker, Jakob, Hoffmann, Boris, Servatius, Helge ORCID: 0000-0003-2887-8707, Aydin, Ali, Nuehrich, Jana, Akbulak, Oezge, Schreiber, Doreen, Schaeffer, Benjamin, Rostock, Thomas, Willems, Stephan and Steven, Daniel (2015). Necessity of epicardial ablation for ventricular tachycardia after sequential endocardial approach. Int. J. Cardiol., 182. S. 56 - 62. CLARE: ELSEVIER IRELAND LTD. ISSN 1874-1754

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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 24 h-Holter ECG were used to evaluate long-term success. Results: One hundred sixty VT ablation procedures in 126 consecutive patients (114 men; age 65 +/- 12 years) 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. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Sultan, ArianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lueker, JakobUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoffmann, BorisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Servatius, HelgeUNSPECIFIEDorcid.org/0000-0003-2887-8707UNSPECIFIED
Aydin, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nuehrich, JanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Akbulak, OezgeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schreiber, DoreenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaeffer, BenjaminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rostock, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Willems, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steven, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-410717
DOI: 10.1016/j.ijcard.2014.12.003
Journal or Publication Title: Int. J. Cardiol.
Volume: 182
Page Range: S. 56 - 62
Date: 2015
Publisher: ELSEVIER IRELAND LTD
Place of Publication: CLARE
ISSN: 1874-1754
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CATHETER ABLATION; RADIOFREQUENCY ABLATION; MYOCARDIAL-INFARCTION; SUBSTRATE; CARDIOMYOPATHY; DEFIBRILLATOR; HEART; SCAR; PREVENTION; SHOCKSMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/41071

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