Special Technology Sessions-6159-Pericardial Access for Epicardial Mapping and Ablation

Video Transcription

Video Summary

In this video, Dr. Roderick Tung discusses the importance of epicardial mapping and ablation in certain cardiac conditions. He explains that traditional endocardial ablation techniques have limited success rates in treating ventricular tachycardia (VT), particularly in cases of ischemic cardiomyopathy. He suggests that this may be because the substrate causing VT can be located anywhere within the myocardial wall, making it difficult to destroy with endocardial ablation alone. <br /><br />Dr. Tung highlights the need for a two-dimensional approach to a complex three-dimensional structure in order to better target and treat VT. He also emphasizes the importance of assessing the presence of epicardial scar tissue and underlying substrate, as they can vary depending on the type of cardiomyopathy. <br /><br />Dr. Tung discusses various techniques for epicardial access, including the use of needles and pericardial windows. He advises on safe practices to avoid complications such as puncturing the right ventricle, damaging coronary arteries, or causing adhesions. He also mentions the need for caution when ablating near the phrenic nerve and suggests the use of techniques to protect coronary arteries during ablation.<br /><br />In conclusion, Dr. Tung highlights the importance of understanding the anatomy and potential complications associated with epicardial mapping and ablation. He suggests that a multidimensional approach is often necessary for successful treatment of certain cardiac conditions.

Keywords

Epicardial mapping

Epicardial ablation

Ventricular tachycardia

Ischemic cardiomyopathy

Two-dimensional approach

Epicardial scar tissue

Epicardial access techniques