Epicardial Ablation Complications

Nicola Tarantino¹, Domenico G Della Rocca², Michela Faggioni³, Xiao-Dong Zhang¹, Sanghamitra Mohanty⁴, Alisara Anannab⁵, Ugur Canpolat⁶, Huseyin Ayhan⁷, Mohamed Bassiouny⁴, Anu Sahore⁴, Kudret Aytemir⁸, Annahita Sarcon⁹, Giovanni B Forleo¹⁰, Carlo Lavalle¹¹, Rodney P Horton⁴, Chintan Trivedi⁴, Amin Al-Ahmad⁴, Jorge Romero¹, David J Burkhardt⁴, Joseph G Gallinghouse⁴, Luigi Di Biase¹², Andrea Natale¹³

Affiliations

¹ Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA.
² Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA. Electronic address: domenicodellarocca@hotmail.it.
³ Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J Peters Veterans Affairs Medical Center, Bronx, NY, USA.
⁴ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA.
⁵ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiovascular Intervention, Central Chest Institute of Thailand, Nonthaburi, Thailand.
⁶ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey.
⁷ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey.
⁸ Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey.
⁹ Division of Electrophysiology, University of California San Francisco, San Francisco, CA, USA.
¹⁰ Department of Cardiology, Azienda Ospedaliera-Universitaria "Luigi Sacco", Milano, Italy.
¹¹ Department of Cardiology, Policlinico Universitario Umberto I, Policlinico Street, Roma 155-00161, Italy.
¹² Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
¹³ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Interventional Electrophysiology, Scripps Clinic, La Jolla, CA, USA; Department of Cardiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Division of Cardiology, Stanford University, Stanford, CA, USA.

PMID: 32771194
DOI: 10.1016/j.ccep.2020.06.004

Review

Epicardial Ablation Complications

Nicola Tarantino et al. Card Electrophysiol Clin. 2020 Sep.

. 2020 Sep;12(3):409-418.

doi: 10.1016/j.ccep.2020.06.004.

Authors

Affiliations

¹ Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA.
² Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA. Electronic address: domenicodellarocca@hotmail.it.
³ Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J Peters Veterans Affairs Medical Center, Bronx, NY, USA.
⁴ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA.
⁵ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiovascular Intervention, Central Chest Institute of Thailand, Nonthaburi, Thailand.
⁶ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey.
⁷ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey.
⁸ Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey.
⁹ Division of Electrophysiology, University of California San Francisco, San Francisco, CA, USA.
¹⁰ Department of Cardiology, Azienda Ospedaliera-Universitaria "Luigi Sacco", Milano, Italy.
¹¹ Department of Cardiology, Policlinico Universitario Umberto I, Policlinico Street, Roma 155-00161, Italy.
¹² Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
¹³ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Interventional Electrophysiology, Scripps Clinic, La Jolla, CA, USA; Department of Cardiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Division of Cardiology, Stanford University, Stanford, CA, USA.

PMID: 32771194
DOI: 10.1016/j.ccep.2020.06.004

Abstract

The percutaneous epicardial approach has become an adjunctive tool for electrophysiologists to treat disparate cardiac arrhythmias, including accessory pathways, atrial tachycardia, and particularly ventricular tachycardia. This novel technique prompted a strong impulse to perform epicardial access as an alternative strategy for pacing and defibrillation, left atrial appendage exclusion, heart failure with preserved ejection fraction, and genetically engineered tissue delivery. However, because of the incremental risk of major complications compared with stand-alone endocardial ablation, it is still practiced in a limited number of highly experienced centers across the world.

Keywords: Cardiac arrhythmia; Complications; Epicardial approach; Percutaneous.

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Conflict of interest statement

Conflicts of interest Dr J.D. Burkhardt is a consultant for Biosense Webster and Stereotaxis. Dr A. Natale has received speaker honoraria from Boston Scientific, Biosense Webster, St. Jude Medical, Biotronik, and Medtronic; and is a consultant for Biosense Webster, St. Jude Medical, and Janssen. All other authors have reported that they have no relationships relevant to the contents of this article to disclose.

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Epicardial Ablation Complications

Affiliations

Epicardial Ablation Complications

Authors

Affiliations

Abstract

Conflict of interest statement

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Medical