Long-term outcomes of combined epicardial and endocardial ablation of monomorphic XXXX related to @entity1121 .

@entity1 @entity2318 @entity1121 @entity1165
BACKGROUND: @entity1165 ( @entity1165 ) is rare in @entity1 with @entity1121 ( @entity1121 ). There are limited data on the utility of catheter ablation for the treatment of @entity1165 in this population. This study details a series of case reports from multiple centers where combined epicardial-endocardial ablation was performed in a highly selected group of @entity1 with @entity1121 -related @entity1165 . METHODS AND RESULTS: The cohort consisted of 10 @entity1 with @entity1121 -related @entity1165 . Pericardial access was achieved using the percutaneous subxyphoid approach. Epicardial and endocardial ventricular 3D bipolar voltage maps were generated. Ablation sites were identified using a combination of entrainment, activation, late/fractionated potential, and pace mapping. Electrophysiological-identified @entity2318 was present in 8 (80%) @entity1 , @entity2318 in 6 (60%), and no scar in 1 (10%). In the 5 @entity1 with inducible, stable @entity1165 , 3 cases were successfully terminated with ablation from the epicardium and 1 from the endocardium. The case that failed catheter ablation required surgical cryoablation to abolish the incessant VT. In the remaining 5 @entity1 , 4 underwent epicardial and endocardial ablation of sites with good pace maps and late/fractionated potentials. No ablation was performed in the remaining @entity1 because of noninducibility and lack of identifiable scar. After 37  17 months (limits, 2 to 62 months; median, 37 months), the freedom from recurrent implantable cardioverter-defibrillator shocks was 78% (7/9 @entity1 ) in those who underwent ablation. CONCLUSIONS: In highly selected @entity1 with @entity1121 , combined epicardial and endocardial mapping and ablation is a feasible and reasonably efficacious option for @entity1165 if refractory to aggressive trials of antiarrhythmic drugs and antitachycardia pacing.
