QTc dispersion as a novel marker in identifying patients requiring an epicardial approach for ablation of scar mediated ventricular tachycardia

• Published in: Indian pacing and electrophysiology journal 2020-07, Vol.20 (4), p.141-146
• Main Authors: Krishnappa, Darshan, Akdemir, Baris, Nantsupawat, Teerapat, Krishnan, Balaji, Can, Ilknur, Adabag, Selcuk, Li, Jian-Ming, Tholakanahalli, Venkatakrishna N.
• Format: Article
• Language: English
• Subjects: Epicardial; Original; QTc dispersion; Ventricular tachycardia
• ISSN: 0972-6292; 0972-6292
• DOI: 10.1016/j.ipej.2020.03.004

Epicardial exit sites of ventricular tachycardia (VT) are frequently encountered during VT ablation requiring an epicardial ablation approach for successful elimination of VT. We sought to assess the utility of repolarization markers in identifying individuals requiring an epicardial ablation approach in addition to an endocardial approach. 32 patients who underwent successful ablation for scar mediated VT were included in the study. Fourteen patients who required a combined endocardial and epicardial VT ablation were defined as epicardial VT group (Epi) whereas 18 patients who were successfully ablated from the endocardium alone constituted the endocardial VT group (Endo). Repolarization markers during sinus rhythm were compared between the two groups. A higher QTc max and QTc dispersion were seen in the Epi group compared to Endo group (479 ± 34 vs 449 ± 20, p = 0.008 and 63 ± 13 vs 38 ± 8, p = 0.001, respectively). Ts-p and Ts-p/Tp-e were higher in the Epi group (166 ± 23 vs 143 ± 23, p = 0.008 and 1.55 ± 0.26 vs 1.3 ± 0.21, p