Universität zu Köln

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:	Creators Email ORCID ORCID Put Code Sultan, Arian UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueker, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Servatius, Helge UNSPECIFIED orcid.org/0000-0003-2887-8707 UNSPECIFIED Aydin, Ali UNSPECIFIED UNSPECIFIED UNSPECIFIED Nuehrich, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Akbulak, Oezge UNSPECIFIED UNSPECIFIED UNSPECIFIED Schreiber, Doreen UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaeffer, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Rostock, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Willems, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-405820
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:	Keywords Language CATHETER ABLATION; RADIOFREQUENCY ABLATION; MYOCARDIAL-INFARCTION; SUBSTRATE; CARDIOMYOPATHY; DEFIBRILLATOR; HEART; SCAR; PREVENTION; SHOCKS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40582