title: Percutaneous epicardial ablation in ventricular arrhythmias.
abstract: BACKGROUND
  Reentrant circuits of ventricular tachycardia may involve not only the endocardium but also the epicardium. Epicardial ablation can be useful in these situations.
  
  
  OBJECTIVE
  The aim of this study was to assess efficacy, safety and complications in a series of consecutive patients who underwent ablation of ventricular tachycardia with epicardial mapping.
  
  
  METHODS
  The study included all patients undergoing ventricular tachycardia ablation with epicardial mapping from 2004 to 2012. Of a total of 95 ablations, an epicardial approach was attempted in nine patients, eight male, mean age 58±12 years. Endocardial mapping was performed in all patients previously or simultaneously. The etiology of the arrhythmia was non-ischemic in eight patients and ischemic in one. We compared the number of events in the six months prior to the epicardial procedure and six months after.
  
  
  RESULTS
  Percutaneous epicardial access was achieved in eight patients. In one case it was not possible due to the presence of adhesions. In none of the patients was the procedure repeated and there were no major complications during hospitalization. In a mean follow-up of 3.5±1.2 years, one patient suffered stroke; there were no other medium-to-long-term complications and the number of ventricular tachycardia episodes was reduced in all patients after ablation.
  
  
  CONCLUSIONS
  Epicardial radiofrequency ablation of ventricular tachycardia was effective in reducing morbidity in eight patients, with a low risk of complications in the short and medium-to-long term.
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal. Electronic address: pedrogalvaosantos@hotmail.com.
authors.forename: Pedro
authors.initials: P
authors.lastname: Galvão Santos
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Diogo
authors.initials: D
authors.lastname: Cavaco
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Adragão
authors.affiliation: Instituto do Coração (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Scanavacca
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Katya
authors.initials: K
authors.lastname: Reis Santos
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Francisco
authors.initials: F
authors.lastname: Belo Morgado
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Carmo
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Francisco
authors.initials: F
authors.lastname: Costa
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Bernardo
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Manuela
authors.initials: M
authors.lastname: Nunes
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Abecasis
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Neves
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Mendes
mesh_terms: D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium; D017180:Tachycardia, Ventricular / Q000601:surgery*; D016896:Treatment Outcome
keywords: Ablação por cateter; Catheter ablation; Epicardial mapping; Mapeamento epicárdico; Taquicardia ventricular; Ventricular tachycardia