Epicardial Ablation

Epicardial Ablation Ankara

Epicardial ablation is a specialized ablation approach. In other words, with a different approach than conventional ablations, the problematic focus in the heart is removed. In short, it is ablation made from the outer membrane of the heart. So what does that mean?

Normal conventional ablations are performed using veins or sometimes arteries in our groin area. Through these vessels, we enter the 4 chambers of the heart and remove the problematic focus on the heart wall by approaching through these heart chambers. So we do the normal ablation from the inside of the heart wall. Epicardial ablation is the opposite. In other words, it is the ablation technique that is done not from inside the heart chambers, but from the outside of the heart wall without using the heart chambers. For all your questions about epicardial ablation, you can contact clinic of Prof. Basri Amasyalı in Ankara.

So Why Do We Do Epicardial Ablation?

In general, 98% of the focuses that cause palpitation are closer to the inner part of the heart wall. Therefore, it is possible to eliminate them with the classical ablation technique. But in the remaining 2% of patients, the focus causing palpitations is closer to the outer part of the heart wall. In some palpitation subgroups, this rate goes up to 30-40%. Therefore, in such cases, ablation performed from the inner part of the heart on the walls of 10-12 mm thickness in the ventricles is insufficient or ineffective. In such cases, epicardial ablation by entering the outer membrane of the heart is the only alternative.

How to Perform Epicardial Ablation?

During this procedure, unlike known ablation procedures, the pericardium is reached with the help of a small needle and catheter from the chest wall, and areas with rhythm disturbances are reached under the pericardium. It is technically more difficult than conventional ablations and is performed in certain centers in Turkey. Since it is a more painful procedure than conventional ablations, deep sedation or, in some cases, general anesthesia is applied to the patient. Below you can see the catheters used during the Epicardial ablation procedure in the images taken from two different patients.

In Which Rhythm Disorders Epicardial Ablation Can Be Required?

Some rhythm disorders originating from the ventricles of the heart described as Ventricular Tachycardia (VT), Wolff-Parkinson-White (WPW) syndrome, Brugada Syndrome, Arrhythmogenic Right Ventricular Dysplasia (ARVD), and a small proportion of supraventricular tachycardias (SVT) are relatively more frequently rhythm disorders that require epicardial ablation.

What is the Risk of Epicardial Ablation?

Of course, the risk is slightly higher than other classical ablations. The greatest risk in this procedure is the possibility of damage to the liver, diaphragm and rarely the intestines. Another risk is the possibility of perforation of the heart wall while trying to get under the pericardium. All of these risks are at 1-2% levels. However, I cannot help but say this. These risks are never more than the life-threatening risk that the rhythm disorder we are trying to eradicate. Moreover, there is no alternative to this procedure, and in most cases, you have a lifelong chance of getting rid of the rhythm disorder.

When I Am Discharged After Epicardial Ablation?

Epicardial ablation does not require an additional hospital stay. Like patients with normal ablation, most patients are discharged after 24 hours.

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