PDirect Home | Quality at UVA | Clinical Trials | Find a Physician | Tools for your Practice | Referring to UVA | CME

Hepatitis C | Pediatric Sleep Disorders | New Hem/Onc Physicians | Epicardial Ablations | Transcatheter Heart Valve Replacement

Epicardial Ablations

UVA Among Largest Treatment Centers in U.S.

Among the approximately 500,000 Americans with ventricular tachycardia (VT), about half have VT on the outside of their heart, says UVA cardiologist Srijoy Mahapatra, M.D. Endocardial ablation procedures, which deliver treatment to the inside of the heart, may not be optimal for this population due to the risk of stroke.

For that reason, epicardial ablation, which delivers radiofrequency energy through a needle to the outside of the heart, is increasingly becoming a first-line treatment option for patients with symptomatic VT, Mahapatra says. Initial research data suggests that because it reaches more areas of the heart, combining epicardial ablation with endocardial ablation may improve the success rate of ablations to treat VT. Because epicardial ablations are performed on the outside of the heart, he says, there is no risk of stroke for patients. Potential candidates for epicardial ablations include VT patients with non-ischemic cardiomyopathy, inferior myocardial infarctions or a particularly wide VT.

More than 60 epicardial ablations have been performed at UVA during the past 18 months, Mahapatra says. He is aided in these procedures by cardiac surgeon Gorav Ailawadi, M.D. Ailawadi is on hand throughout the procedure to ensure a safe ablation and helps Mahapatra access the outside of a patient’s heart, often by either removing fat that blocks access to the epicardium or breaking up adhesions on the epicardium to help create a more effective ablation.

Epicardial ablations are also beginning to be used as a second-line treatment for atrial fibrillation (AF), Mahapatra says, with some early research data showing that performing an epicardial ablation – in addition to an endocardial ablation – may help improve success rates for AF ablations. Mahapatra has performed a handful of epicardial ablations to treat AF, and says at this point that epicardial ablations are generally an option for AF patients who did not respond to an endocardial ablation.

Leading-edge treatment for ventricular tachycardia is among the comprehensive services offered through UVA’s Electrophysiology Lab. Procedures include pacemaker, cardiac resynchronization defibrillator and implantable cardioverter defibrillator implantations; ablations for VT, AF and supraventricular tachycardia; and treatment for pediatric and congenital heart disease.

To refer patients for an epicardial ablation for ventricular tachycardia, call UVA Physician Direct at 800.552.3723.