Epicardial Access Should Be Part of Every Structural VT Ablation Case-Epicardial Access Should Be Part of Every Structural VT Ablation Case

Video Transcription

Video Summary

Dr. Roderick Tang from the University of Arizona and Dr. Frederic Sacher from Bordeaux University debated the necessity of epicardial access mapping and ablation for structural ventricular tachycardia (VT) ablation at the Heart Rhythm Society's 45th Annual Meeting in San Diego. Dr. Tang argues in favor, emphasizing the importance of epicardial mapping to improve the success rate of VT ablations, especially in cases involving complex reentrant circuits that may only be accessible from the epicardium. He highlights the need for advanced mapping technologies and safer access techniques for epicardial ablation, such as CO2 insufflation. Dr. Sacher, on the contrary, argues that epicardial access should not be routinely used for all scar-related VT ablations. He stresses the importance of patient selection, imaging, and mapping techniques to identify cases where epicardial intervention is truly necessary. Dr. Sacher points out the associated risks, such as heart perforation, and advocates for experienced centers to perform these procedures. Both debaters agree that while epicardial mapping provides valuable insights, its routine use should be carefully considered based on individual patient needs, highlighting the need for ongoing research and development in safer procedural methods.

Keywords

epicardial access

ventricular tachycardia

VT ablation

Heart Rhythm Society

epicardial mapping

CO2 insufflation

patient selection

heart perforation

advanced mapping technologies