{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T09:52:12Z","timestamp":1785750732325,"version":"3.56.0"},"reference-count":35,"publisher":"Radcliffe Medical Media Ltd","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p>Epicardial ablation is needed to eliminate ventricular tachycardia (VT) in some patients with nonischaemic cardiomyopathy. The 12-lead electrocardiogram of VT, pre-procedural imaging and endocardial unipolar voltage maps can predict a high likelihood of epicardial substrate and VT. A septal VT substrate may preclude the need for epicardial access and mapping and can be identified with imaging, pacing and voltage mapping. Pericardial access is usually obtained prior to systemic anticoagulation or after reversal of systemic anticoagulation. A unique set of complications can be encountered with epicardial access, mapping and ablation, which include haemopericardium, phrenic nerve injury, damage to major coronary arteries and pericarditis. Anticipating, preventing and, if necessary, managing these complications are paramount for patient safety. Best practices are reviewed.<\/jats:p>","DOI":"10.15420\/aer.2018.10.2","type":"journal-article","created":{"date-parts":[[2018,9,16]],"date-time":"2018-09-16T00:12:12Z","timestamp":1537056732000},"page":"159","source":"Crossref","is-referenced-by-count":27,"title":["Practical Guide to Ablation for Epicardial Ventricular Tachycardia: When to Get Access, How to Deal with Anticoagulation and How to Prevent Complications"],"prefix":"10.15420","volume":"7","author":[{"given":"Ramanan","family":"Kumareswaran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis E","family":"Marchlinski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Cardiac Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Cardiac Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6096","reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1056\/NEJMoa1513614","article-title":"Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs","volume":"375","author":"Sapp","year":"2016","unstructured":"1. 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Postmyocarditis ventricular tachycardia in patients with epicardial-only scar: A specific entity requiring a specific approach. J Cardiovasc Electrophysiol 2015;26:42-50.","journal-title":"J Cardiovasc Electrophysiol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1161\/CIRCEP.110.957290","article-title":"Long-term outcomes of combined epicardial and endocardial ablation of monomorphic ventricular tachycardia related to hypertrophic cardiomyopathy","volume":"4","author":"Dukkipati","year":"2011","unstructured":"13. Dukkipati SR, d'Avila A, Soejima K, et al. Long-term outcomes of combined epicardial and endocardial ablation of monomorphic ventricular tachycardia related to hypertrophic cardiomyopathy. 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ECG criteria to identify epicardial ventricular tachycardia in nonischemic cardiomyopathy. Circ Arrhythm Electrophysiol 2010;3:63-71.","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.1161\/01.CIR.0000125525.04081.4B","article-title":"Electrocardiographic recognition of the epicardial origin of ventricular tachycardias","volume":"109","author":"Berruezo","year":"2004","unstructured":"16. Berruezo A, Mont L, Nava S, et al. Electrocardiographic recognition of the epicardial origin of ventricular tachycardias. Circulation 2004;109:1842-7.","journal-title":"Circulation"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"17. Hayashi T. Santangeli P, Pathak R, et al. Outcomes of catheter ablation of idiopathic outflow tract ventricular arrhythmias with an R wave pattern break in lead V2: A distinct clinical entity. 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