BACKGROUND: There is no consensus on the appropriate indications for the epicardial approach in substrate ablation of @entity583 ( @entity583 ) @entity1165 ( @entity1165 ). OBJECTIVE: The purpose of this study was to investigate whether @entity1188 ( @entity1188 ) could identify @entity1 who would benefit from a combined first-line endo-epicardial approach. METHODS: Before ablation, @entity1188 was assessed by contrast-enhanced cardiac magnetic resonance imaging (hyperenhancement >= 75% of the wall thickness in >= 1 segment), echocardiography ( @entity910 / @entity910 + hyperrefringency + wall thinning), computed tomography (wall thinning), or scintigraphy (transmural @entity39 ). Prospectively from January 2011, an endocardial approach was used in @entity1 with @entity583 (group 1) and a combined endo-epicardial approach in @entity1 with transmural @entity583 (group 2). Outcomes in both groups were compared with those in @entity1 with transmural @entity583 and only endocardial approach due to previous cardiac surgery or procedure performed before January 2011 (group 3). The primary end point was @entity1165 / @entity2224 recurrence-free survival. RESULTS: Ninety @entity1 (92.2% @entity1 ; mean age 67.4    9.8 years) undergoing @entity1165 substrate ablation were included: group 1, n = 34; group 2, n = 24; group 3, n = 32. During a mean follow-up duration of 22.5    13.7 months, 5 @entity1 in group 1 (14.7%), 3 @entity1 in group 2 (12.5%), and 13 @entity1 in group 3 (40.6%) had @entity1165 recurrences (P = .011). Time to recurrence was the shortest in group 3 (log-rank, P = .018). The endocardial approach in @entity1 with transmural @entity583 was associated with an increased risk of recurrence (hazard ratio 4.01; 95% confidence interval 1.41-11.3; P = .009). CONCLUSION: The endocardial approach in @entity1 with transmural @entity583 undergoing @entity1165 substrate ablation is associated with an increased risk of recurrence. @entity1188 may be a useful criterion for the selection of a first-line combined endo-epicardial approach.

Infarct transmurality as a criterion for first-line endo-epicardial substrate-guided XXXX in ischemic cardiomyopathy.

@entity1 :: ('9606', 'Species') :: ['patients', 'men'] @entity1165 :: ('MESH:D017180', 'Disease') :: ['VT', 'ventricular tachycardia'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity910 :: ('MESH:D004409', 'Disease') :: ['dyskinesia', 'akinesia'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['IT', 'infarct transmurality'] @entity2224 :: ('MESH:D014693', 'Disease') :: ['ventricular fibrillation'] @entity583 :: ('MESH:D009203', 'Disease') :: ['subendocardial MI', 'MI', 'post-myocardial infarction']
@entity1165 :: (MESH:D017180,Disease) :: ['ventricular tachycardia ablation']
