Safety and feasibility of closed chest epicardial catheter ablation using electroporation.

Epicardial Catheter Ablation Using High-Intensity Ultrasound: Validation in a Swine Model.

BACKGROUND Epicardial radiofrequency catheter ablation of ventricular tachycardia remains challenging because of the presence of deep myocardial scar and adjacent cardiac structures, such as the coronary arteries, phrenic nerve, and epicardial fat that limit delivery of radiofrequency energy. High-intensity ultrasound (HIU) is an acoustic energy source able to deliver deep lesions through fat, ...

Subxiphoid surgical approach for epicardial catheter-based mapping and ablation in patients with prior cardiac surgery or difficult pericardial access.

BACKGROUND Percutaneous epicardial mapping and ablation are successful in some patients with ventricular epicardial reentry circuits but may be impossible when pericardial adhesions are present, such as from prior cardiac surgery. The purpose of this study was to evaluate the feasibility of direct surgical exposure of the pericardial space to allow catheter epicardial mapping and ablation in th...

Myocardial Lesion Size after Epicardial Electroporation Catheter Ablation following Subxiphoid Puncture

Myocardial lesion depth with circular electroporation ablation.

BACKGROUND Recently, we demonstrated the feasibility and safety of circular electroporation ablation in porcine pulmonary vein ostia, but the relationship between the magnitude of the application and lesion dimensions is still unknown. METHODS AND RESULTS An in vivo porcine study was performed on left ventricular epicardium submerged under 10 mm of blood, using devices that mimic a 20-mm-diam...

Epicardial approach to the ablation of ventricular tachycardia in coronary artery disease: an alternative or ancillary approach.

In this issue of the Journal, Sosa et al. (1) evaluate the feasibility, safety and efficacy of an epicardial approach to ablate ventricular tachycardia secondary to myocardial infarction. Sosa and his colleagues have recently introduced the technique of epicardial mapping to approach and ablate ventricular tachycardia due to Chagas’ disease (2,3). The technique involves introducing a standard a...