Epicardial Ablation via Arterial and Venous Systems

Card Electrophysiol Clin. 2020 Sep;12(3):391-399. doi: 10.1016/j.ccep.2020.06.006. Epub 2020 Jul 8.

Abstract

The intracoronary artery and venous routes provide unique roadmaps for mapping and interventions for ventricular arrhythmias and certain atrial arrhythmias. The unique anatomic location of these vessels on the epicardial surface enables mapping/interventions without the need to access the pericardial space. These anatomic routes also track deep into certain intramural regions, with interventions that are not accessible from either epicardial or endocardial routes. To map smaller vessels, multipolar catheters and wires are used to record local electrograms. Endocardial/epicardial ablation at adjacent sites is sometimes required to enhance successful outcomes. This article describes tools, techniques, and site-specific mapping and interventions.

Keywords: Ablation; Arterial; Intracoronary; Venous; Ventricular arrhythmias.

Publication types

  • Review

MeSH terms

  • Arrhythmias, Cardiac* / diagnostic imaging
  • Arrhythmias, Cardiac* / surgery
  • Catheter Ablation*
  • Coronary Vessels / diagnostic imaging*
  • Epicardial Mapping*
  • Humans
  • Pericardium* / diagnostic imaging
  • Pericardium* / surgery