{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T09:35:04Z","timestamp":1791106504614,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,4,20]],"date-time":"2007-04-20T00:00:00Z","timestamp":1177027200000},"content-version":"vor","delay-in-days":3337,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[1998,3]]},"abstract":"<jats:p>Nonsurgical Epicardial Ablation. <jats:italic>Introduction<\/jats:italic>: An epicardial site of origin of ventricular tachycardia (VT) may explain unsuccessful endocardial radiofrequency (RF) catheter ablation. A new technique to map the epicardial surface of the heart through pericardial puncture was presented recently and opened the possibility of using epicardial mapping to guide endocardial ablation or epicardial catheter ablation. We report the efficacy and safety of these two approaches to treat 10 consecutive patients with VT and Chagas\u2019 disease.<\/jats:p><jats:p> <jats:italic>Methods and Results<\/jats:italic>: Epicardial mapping was carried out with a regular steerable catheter introduced into the pericardial space. An epicardial circuit was found in 14 of 18 mapable VTs induced in 10 patients. Epicardial mapping was used to guide endocardial ablation in 4 patients and epicardial ablation in 6. The epicardial earliest activation site occurred 107 \u00b1 60 msec earlier than the onset of the QRS complex. At the epicardial site used to guide endocardial ablation, earliest activation occurred 75 \u00b1 55 msec before the QRS complex. Epicardial mid\u2010diastolic potentials and\/or continuous electrical activity were seen in 7 patients. After 4.8 \u00b1 2.9 seconds of epicardial RF applications, VT was rendered noninducible. Hemopericardium requiring drainage occurred in 1 patient; 3 others developed pericardial friction without hemopericardium. Patients remain asymptomatic 5 to 9 months after the procedure. Interruption during endocardial pulses occurred after 20.2 \u00b1 14 seconds (P = 0.004), hut VT was always reinducible and the patients experienced a poor outcome.<\/jats:p><jats:p> <jats:italic>Conclusion<\/jats:italic>: Epicardial mapping does not enhance the effectiveness of endocardial pulses of RF. Epicardial applications of RF energy can safely and effectively treat patients with VT and Chagas\u2019 disease.<\/jats:p>","DOI":"10.1111\/j.1540-8167.1998.tb00907.x","type":"journal-article","created":{"date-parts":[[2007,4,20]],"date-time":"2007-04-20T14:46:50Z","timestamp":1177080410000},"page":"229-239","source":"Crossref","is-referenced-by-count":280,"title":["Endocardial and Epicardial Ablation Guided by Nonsurgical Transthoracic Epicardial Mapping to Treat Recurrent Ventricular Tachycardia"],"prefix":"10.1111","volume":"9","author":[{"given":"EDUARDO","family":"SOSA","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MAURICIO","family":"SCANAVACCA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ANDRE","family":"D'AVILA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JO\u00c3O","family":"PICCIONI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"OSVALDO","family":"SANCHEZ","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOS\u00c9 L.","family":"VELARDE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MARCIO","family":"SILVA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BASILEO","family":"REOL\u00c3O","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,4,20]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"417","volume-title":"Clinical Cardiac Electrophysiology","author":"Josephson ME","year":"1993"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1995.tb00370.x"},{"key":"e_1_2_1_4_2","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1016\/0735-1097(90)92832-M","article-title":"Ventricular tachycardia In the infarcted, Langendorffperfused human heart: Role of the arrangement of surviving cardiac fibers","volume":"15","author":"Bakker JMT","year":"1990","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90760-7"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.77.3.589"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.87.2.363"},{"key":"e_1_2_1_8_2","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1161\/01.CIR.88.4.1647","article-title":"Identification of reentry circuit sites during catheter mapping and radiofrequency ablation of VT late after myocardial infarction","volume":"88","author":"Stevenson WG","year":"1993","journal-title":"Circulation"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90147-3"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.12.3481"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)91902-A"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.5.1159"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.3.1094"},{"key":"e_1_2_1_14_2","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/S0735-1097(10)80184-6","article-title":"Concealed entrainment as a guide for ventricular tachycardia in patients with prior myocardial Infarction","volume":"17","author":"Morady P","year":"1991","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1992.tb05137.x"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.77.4.806"},{"key":"e_1_2_1_17_2","first-page":"1058","article-title":"Epicardial and endocardial mapping of ventricular tachycardia in patients with myocardial Infarction","volume":"84","author":"Kaltenbrunner W","year":"1991","journal-title":"Is the origin of the tachycardia always subendocardially localized? Circulation"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1994.tb01422.x"},{"key":"e_1_2_1_19_2","doi-asserted-by":"crossref","first-page":"53l","DOI":"10.1111\/j.1540-8167.1996.tb00559.x","article-title":"A new technique to perform epicardial mapping in the electrophysiology laboratory","volume":"7","author":"Sosa E","year":"1996","journal-title":"J Cardiovasc Electrophysiol"},{"key":"e_1_2_1_20_2","article-title":"Radiofrequency catheter ablation of ventricular tachycardia guided by non\u2010surgical epicardial mapping in chronic Chagasic heart disease","author":"Sosa E","year":"1998","journal-title":"PACE"},{"key":"e_1_2_1_21_2","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/0735-1097(90)90194-T","article-title":"Termination sequence of ventricular tachycardia with epicardial laser photocoagulation: A clinical comparison with patients undergoing successful endocardial photocoagulation alone","volume":"15","author":"Svenson RH","year":"1990","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(10)80280-3"},{"key":"e_1_2_1_23_2","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1161\/01.CIR.83.5.1577","article-title":"Functional role of ventricular tachycardia. Observations derived from computerized epicardial activation mapping, entrainment, and epicardial laser photoablation","volume":"83","author":"Littman L","year":"1991","journal-title":"Circulation"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.94.12.3221"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-31801995000200016"},{"key":"e_1_2_1_26_2","first-page":"58","article-title":"Successful catheter ablation of the origin of recurrent ventricular tachycardia in chronic chagasic heart disease","volume":"1","author":"Sosa E","year":"1987","journal-title":"J Electrophysiol"},{"key":"e_1_2_1_27_2","first-page":"443","volume-title":"Elefrnfisiologia Cl\u00ednica e Intervencionista das Arritmias Card\u00edacas","author":"Sosa E","year":"1997"},{"key":"e_1_2_1_28_2","first-page":"611","article-title":"Idiopathic epicardial outflow tract ventricular tachycardia: Implications for RF catheter ablation","volume":"19","author":"Arruda M","year":"1996","journal-title":"PACE"},{"key":"e_1_2_1_29_2","first-page":"202A","article-title":"Coronary venous mapping in patients with sustained ventricular tachycardia","volume":"29","author":"Paola AAV","year":"1997","journal-title":"J Am Coll Cardiol"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1540-8167.1998.tb00907.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1540-8167.1998.tb00907.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T07:24:23Z","timestamp":1698477863000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1540-8167.1998.tb00907.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,3]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1998,3]]}},"alternative-id":["10.1111\/j.1540-8167.1998.tb00907.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1540-8167.1998.tb00907.x","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,3]]}}}