{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:39:34Z","timestamp":1791319174570,"version":"4.3.1"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T00:00:00Z","timestamp":1592438400000},"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":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The pathologic process of ARVC (arrhythmogenic right ventricular cardiomyopathy) typically originates in the epicardium or subepicardial layers with progression toward endocardium. However, in the most recent ARVC international task force consensus statement, epicardial ventricular tachycardia (VT) ablation is recommended as a Class I indication only in patients with at least one failed endocardial VT ablation attempt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this meta\u2010analysis is to assess the outcomes of ARVC patients undergoing combined endo\u2010epicardial VT ablation, as compared to endocardial ablation alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of PubMed, Embase, and Cochrane was performed for studies reporting clinical outcomes of endo\u2010epicardial VT ablation vs endocardial\u2010only VT ablation in patients with ARVC. Fixed\u2010Effect model was used if I<jats:sub>2<\/jats:sub> &lt; 25 and the Random\u2010Effects Model was used if I<jats:sub>2<\/jats:sub> \u2265 25%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine studies consisting of 452 patients were included (mean age 42.3\u2009\u00b1\u20095.7\u2009years; 70% male). After a mean follow\u2010up of 48.1\u2009\u00b1\u200921.5\u2009months, endo\u2010epicardial ablation was associated with 42% relative risk reduction in VA recurrence as opposed to endocardial ablation alone (risk ratio [RR], 0.58; 95% confidence interval [CI], 0.45\u20100.75; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001). No significant differences were noted between endo\u2010epicardial and endocardial VT ablation groups in terms of all\u2010cause mortality (RR, 1.19; 95% CI, 0.03\u201047.08; <jats:italic>P<\/jats:italic>\u2009=\u2009.93) and acute procedural complications (RR, 5.39; 95% CI, 0.60\u201048.74; <jats:italic>P<\/jats:italic>\u2009=\u2009.13).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that in patients with ARVC, endo\u2010epicardial VT ablation is associated with a significant reduction in VA recurrence as opposed to endocardial ablation alone, without a significant difference in all\u2010cause mortality or acute procedural complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14593","type":"journal-article","created":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T11:29:22Z","timestamp":1591010962000},"page":"2022-2031","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Endo\u2010epicardial ablation vs endocardial ablation for the management of ventricular tachycardia in arrhythmogenic right ventricular cardiomyopathy: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6420-8669","authenticated-orcid":false,"given":"Jorge","family":"Romero","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Montefiore Medical Center Albert Einstein College of Medicine  Bronx New 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