Epicardial Radiofrequency Ablation Failure During Ablation Procedures for Ventricular Arrhythmias Reasons and Implications for Outcomes
作者： Samuel H. Baldinger , Saurabh Kumar , Chirag R. Barbhaiya , Saagar Mahida , Laurence M. Epstein
DOI: 10.1161/CIRCEP.115.003202
关键词:
摘要: Background —Radiofrequency ablation (RFA) from the epicardial space for ventricular arrhythmias (VAs) is limited or impossible in some cases. Reasons failure and impact on outcome have not been systematically analyzed. Methods Results —We assessed reasons RFA relative to anatomical target area type of heart disease, failed after procedures VAs a large single-center cohort. Epicardial access was attempted during 309 277 patients, achieved 291 (94%). Unlimited an identified region could be performed 181 cases (59%), possible 22 (7%), deemed feasible 88 (28%). were unsuccessful (6%), identify (15%), proximity coronary artery (13%), phrenic nerve (6%) complications (<1%). impeded majority targeting left (LV) summit region. Acute occurred 9%. The risk acute 8.3 times higher (4.5-15.0, p <0.001) no compared unlimited patients with had better recurrence-free-survival rates ( <0.001). Conclusions —Epicardial often even when pericardial successful. Variability success dependent presence factors limiting associated worse outcomes.
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