Hands On
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.Recording and interpreting unipolar electrograms to guide catheter ablation
Electrophysiology laboratories commonly use closely spaced bipolar recordings for mapping. However, unipolar recordings have some useful features that can provide additional complimentary information, provided the limitations of these recordings and the particular recording techniques are recognized.Catheter ablation in tetralogy of Fallot
Tetralogy of Fallot is the most common form of cyanotic heart disease, accounting for approximately 10% of congenital heart defects. Corrective surgery involves atrial and/or ventricular incisions and patches that, when combined with altered hemodynamics, predispose to the late onset of arrhythmias.1,2 In a multicenter cohort followed up for 35 years after corrective surgery, sustained atrial and ventricular tachyarrhythmias occurred in 10% and 12% of patients, respectively.1 Macroreentrant right atrial tachycardia is the most common atrial arrhythmia.
