The Lead Episode 2: A Discussion of Epicardial Roof-Dependent Macro-Reentrant Tachycardia-The Lead Episode 2

Video Transcription

Video Summary

In this episode of The Lead, the hosts discuss a recent study on epicardial roof-dependent macro-reentrant tachycardia after ablation of atrial fibrillation. The study looked at patients with this type of tachycardia and found that about a third had a presumed epicardial circuit. They defined the circuit by looking at entrainment and mapping activation patterns. The study found that patients with epicardial circuits had longer durations of atrial fibrillation and a higher percentage of prior posterior wall ablation. The hosts discuss the challenges of ablating the roof region, with tissue thickness and the presence of fat being potential factors. They also discuss the use of alcohol ablation and non-radiofrequency approaches like pulse field ablation. The hosts suggest strategies for safely targeting the roof region and preventing these iatrogenic flutters. They consider the role of pre-ablation imaging and discuss the potential of epicardial mapping for difficult cases.

Keywords

epicardial roof-dependent macro-reentrant tachycardia

ablation of atrial fibrillation

entrainment

mapping activation patterns

prior posterior wall ablation

roof region ablation