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Europace Advance Access published online on March 8, 2007
Europace, doi:10.1093/europace/eum016
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

CASE REPORT

Epicardial catheter ablation of ventricular tachycardia using surgical subxyphoid approach

P. Maury*, B. Leobon, A. Duparc, M. Delay and M. Galinier

Federation of Cardiology, University Hospital Rangueil, 31059 Toulouse Cedex 09, France

We report the case of a patient presenting with a previous inferior myocardial infarction complicated by incessant monomorphic ventricular tachycardia resistant to antiarrhythmic drugs. Because endocardial catheter ablation failed and because of focal endocardial activation arising from the left ventricular inferior wall, an epicardial location of the reentry circuit was suspected. Catheter mapping of the pericardial space through a surgical subxyphoid approach performed in the electrophysiological laboratory confirmed the epicardial location of the arrhythmogenic substrate and allowed us successfully to ablate and cure the patient. Surgical subxyphoid approach can be performed in the electrophysiological laboratory when epicardial ablation is needed in case of inadvisable, difficult, or failed non-surgical percutaneous access.

Key Words: Epicardial ventricular tachycardia, Epicardial catheter ablation, Surgical subxyphoid approach

* Corresponding author: Tel: +33 5 61 32 20 94; fax: +33 5 61 32 22 46. E-mail address: mauryjphil{at}hotmail.com

Manuscript submitted 17 September 2006. Accepted after revision 31 December 2006.


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