Repeat Percutaneous Epicardial Mapping and Ablation of Ventricular Tachycardia: Safety and Outcome

摘要: Safety and Efficacy of Repeat Epicardial Access. Introduction: mapping ablation ventricular tachycardia (VT) has been increasingly performed. Occasionally additional is necessary, requiring repeat percutaneous access to the pericardial space. Methods Results: We studied 30 consecutive patients who required a epicardial procedure. specifically examined success safety as well ability map ablate VT targets. Percutaneous at median 110 days after last procedure was successful in all patients. Significant adhesions interfering with catheter were encountered 7 (23%); 6 had received intrapericardial triamcinolone acetate (IPTA) prior procedures. Using blunt dissection deflected steerable sheath, divided allowing for complete 5 areas dense adherence compartmentalizing pericardium 1 patient precluding over previously targeted site second. Targeted noninducibility achieved 27 (90%) including adhesions. No direct complications related or disruption occurred. One periprocedural death occurred from refractory cardiogenic shock LV ejection fraction 10%. Another developed asymptomatic positive Haemophilus influenzae fluid cultures identified second procedure, which successfully treated. Conclusions: can be obtained ablation. Adhesions procedures may limit mapping, but usually disrupted mechanically allow recurrent VT. IPTA not completely prevent (J Cardiovasc Electrophysiol, Vol. 23, pp. 744-749, July 2012)