{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:21:59Z","timestamp":1790180519839,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T00:00:00Z","timestamp":1562025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The efficacy of\u00a0endocardial catheter ablation for ventricular tachycardia (VT) can be limited by intramural or epicardial substrates. Adding epicardial mapping and ablation may improve arrhythmia outcomes compared with an endocardial\u2010only approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a systematic review and meta\u2010analysis of studies comparing a strategy of endo\u2010epicardial catheter ablation to an endocardial\u2010only approach for VT. Subanalyses were performed for ischemic and nonischemic cardiomyopathies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 22 studies including 1138 patients were included in the meta\u2010analysis. Of those, 44% underwent an endo\u2010epicardial approach. During intermediate to long\u2010term follow\u2010up (average 7 to 70 months), recurrent VT or appropriate implantable cardioverter defibrillator (ICD) therapies were significantly lower with the endo\u2010epicardial strategy (OR, 0.52; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01). All\u2010cause mortality was also lower in this group (OR, 0.50; <jats:italic>P<\/jats:italic>\u2009=\u2009.03). No difference between endo\u2010epicardial and endocardial\u2010only ablation was noted in nonischemic cardiomyopathies. Among 323 patients with ischemic cardiomyopathy, recurrent VT or appropriate ICD therapies was less frequent in the endo\u2010epicardial group (OR, 0.39; <jats:italic>P<\/jats:italic>\u2009=\u2009.01), as was all\u2010cause mortality (OR, 0.38; <jats:italic>P<\/jats:italic>\u2009=\u2009.05). In patients with arrhythmogenic right ventricular cardiomyopathy, recurrent VT or appropriate ICD therapy was also lower in the endo\u2010epicardial group (OR, 0.42; <jats:italic>P<\/jats:italic>\u2009=\u2009.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results suggest that a strategy of combined endo\u2010 and epicardial access for mapping and ablation of VT may provide superior efficacy to an endocardial\u2010only approach in selected patients. Randomized trials are warranted to further investigate this question.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14013","type":"journal-article","created":{"date-parts":[[2019,6,7]],"date-time":"2019-06-07T05:14:29Z","timestamp":1559884469000},"page":"1537-1548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Endo\u2010epicardial vs endocardial\u2010only catheter ablation of ventricular tachycardia: A meta\u2010analysis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3622-7605","authenticated-orcid":false,"given":"Rhanderson","family":"Cardoso","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine Johns Hopkins Medical Institutions Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio R.","family":"Assis","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Johns Hopkins Medical Institutions Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"D\u2019Avila","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Service Hospital SOS Cardio Florianopolis SC 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