INTRODUCTION: An epicardial site of origin of @entity1165 ( @entity1165 ) 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 @entity1 with @entity1165 and @entity1526 . METHODS AND RESULTS: 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 @entity1 . Epicardial mapping was used to guide endocardial ablation in 4 @entity1 and epicardial ablation in 6. The epicardial earliest activation site occurred 107+/-60 msec earlier than the onset of the QRS complex. At the epicardial site used to guide endocardial ablation, earliest activation occurred 75+/-55 msec before the QRS complex. Epicardial mid-diastolic potentials and/or continuous electrical activity were seen in 7 @entity1 . After 4.8+/-2.9 seconds of epicardial RF applications, @entity1165 was rendered noninducible. @entity2294 requiring drainage occurred in 1 @entity1 ; 3 others developed @entity2294 without @entity2294 . @entity1 remain asymptomatic 5 to 9 months after the procedure. Interruption during endocardial pulses occurred after 20.2+/-14 seconds (P = 0.004), but @entity1165 was always reinducible and the @entity1 experienced a poor outcome. CONCLUSION: Epicardial mapping does not enhance the effectiveness of endocardial pulses of RF. Epicardial applications of RF energy can safely and effectively treat @entity1 with @entity1165 and @entity1526 .

Endocardial and epicardial ablation guided by nonsurgical transthoracic epicardial mapping to treat recurrent XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity1165 :: ('MESH:D017180', 'Disease') :: ['VT', 'ventricular tachycardia'] @entity1526 :: ('MESH:D014355', 'Disease') :: ["Chagas' disease"] @entity2294 :: ('MESH:D010490', 'Disease') :: ['Hemopericardium', 'pericardial friction', 'hemopericardium']
@entity1165 :: (MESH:D017180,Disease) :: ['ventricular tachycardia']
