Abstract 19318: Value of a Combined Epicardial-Endocardial Ablation Strategy for Ventricular Tachycardia Storm
Background: Epicardial mapping and ablation has been shown to be a useful adjunct in the setting of ventricular tachycardia (VT) storm. The aim of this study is to report ablation outcomes in 53 consecutive VT storm cases in patients with ischemic (ICM) and non-ischemic cardiomyopathy (NICM), and compare the results of an combined epicardial-endocardial (epi-endo) versus endo-only ablation strategy.
Methods: Patients with VT storm referred for ablation between 6/04-6/11 were analyzed into two groups: ICM and NICM. Six month freedom from VT recurrence was compared between patients who underwent combined epi-endo with those who underwent endocardial-only ablation strategy.
Results: 53 patients (ICM=26, NICM=27) underwent ablation for VT storm. In the ICM group, there was significantly higher freedom from VT recurrence at 6 months in the epi-endo group compared to the endo-only ablation group (80% vs. 38%, p = 0.03). In the NICM group, there was no difference in freedom from VT recurrence at 6 months in the epi-endo group compared to the endo-only ablation group (25% vs. 31%, p = 0.75).
Conclusion: A combined epi-endo ablation resulted in significantly better outcomes compared to endo-only ablation in patient with ICM. No difference was seen for the NICM group. A combined epi-endo should be considered initially in patients with ICM presenting with VT storm.
- © 2012 by American Heart Association, Inc.