Epicardial ablations targets radiofrequency energy to the outside of the heart, which can resolve complex cases of ventricular tachycardia. Sometimes ventricular tachycardia ablation involves treatment inside the heart and outside the heart at the same time.
Radiofrequency ablation or cryoablation can be used during epicardial ablation.
If an abnormal heartbeat is being caused by tissue on the outside of the heart, a physician may use a long needle to access the heart. The needle is inserted through the skin on the patient’s chest and advanced through the lining of the pericardium surrounding the heart. A sheath and catheters are used to access the outside of the heart.
Most patients being considered for epicardial ablation have already had an attempted catheter ablation procedure. During this ablation there is usually evidence that the arrhythmia focus is not located on the inside of the heart. In some patients there may be ECG clues that the focus is more likely to be epicardial in location. Patients with ventricular tachycardia without coronary artery disease are statistically frequently found to have the heart rhythm problem on the outside of the heart.
Patients may experience chest discomfort after the epicardial ablation because some degree of pericarditis (inflammation of the thin sac-like membrane surrounding the heart) usually occurs. Patients are often given medications that reduce the irritation.