The utility of manually controlled steerable sheath in epicardial mapping and ablation procedure in patients with ventricular tachycardia.

AIMS: The aim of this study is to evaluate the benefit of manually controlled steerable sheath, which provides greater flexibility and stability, in mapping and ablation procedure of ventricular tachycardia. METHODS AND RESULTS: We retrospectively reviewed 40 patients who underwent epicardial mapping and conclusive ablation. The first attempt to reach the primary endpoint defined as successful creation of detailed map of entire epicardial space and was achieved in 16 patients. Among the remaining 24 patients, we used the steerable sheath and achieved further success to create an entire map in all patients. After the delivery of RF energy, final procedural success was defined as complete abolishment of late potential and no more induction of any VT, and that was obtained in 10 out of 16 patients mapped with conventional sheath and 21 out of 24 patients with steerable sheath. The advantage of the steerable sheath seemed to be consistent, regardless of the site of ablation. There was no procedure-related adverse event. CONCLUSIONS: The manually controlled steerable sheath was safe and effective to achieve procedural success in patients with epicardial VT.