Epicardial ablation: reducing the risks.

摘要

The epicardial approach for treating patients with recurrent ventricular tachycardia (VT) has steadily increased in popularity since the initial description by Sosa and colleagues in 1996. A potential risk during epicardial ablation is damage to a coronary artery. The article by Thyer and associates2 in this issue of the journal describes a technique for protecting the coronary arteries during epicardial radiofrequency (RF) ablation by infusing intracoronary chilled saline. In order to put the results of this article in context with the general procedure of epicardial ablation, three questions need to be addressed. (1) How important is epicardial ablation to the management of patients with VT? (2) How much of a risk is coronary occlusion during epicardial ablation? (3) Will ice infusion work when applied to the beating human heart during an ablation procedure?