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How to perform an epicardial ventricular tachycardia ablation: A contemporary and practical approach
Catheter ablation is increasingly used for the treatment of cardiac arrhythmias. In the 1990s, in order to treat ventricular arrhythmias resulting from chagasic cardiomyopathy, Sosa et al1 developed a technique to enter the pericardium percutaneously in the absence of a pericardial effusion. Since then, “dry” epicardial access has become a regular part of complex catheter ablation. In this review, we concentrate on the technical aspects of performing epicardial ablation for ventricular tachycardia (VT), including the management of potential complications.Safety and prevention of complications during percutaneous epicardial access for the ablation of cardiac arrhythmias
Since its introduction, percutaneous epicardial access is increasingly being performed to facilitate catheter ablation of ventricular tachycardias (VTs) with epicardial circuits, difficult cases of idiopathic VTs, focal atrial tachycardia, and accessory pathways that cannot be successfully targeted endocardially.1 A thorough understanding of the clinical anatomy and potential complications is vital in order to perform a safe procedure.2 In this article, we present the clinical anatomy related to epicardial access, the technique of performing a subxiphoid epicardial puncture, and various measures to prevent complications.
