Epicardial ventricular tachycardia ablation an evolution of needs.

D m eferral for epicardial ablation frequently represents a “last itch” effort in uniquely difficult patients. Epicardial maping was the cornerstone that guided our early experience in he surgical ablation of arrhythmias (1). However, epicardial apping alone was insufficient to identify the site of origin of entricular tachycardias (VTs), particularly in patients with oronary artery disease and myocardial infarctions (2,3).