NCT05888662: EPIC-VT

Endo-epicardial vs Endocardial-only Catheter Ablation of Ventricular Tachycardia in Patients With Ischemic Cardiomyopathy (EPIC-VT)

Recruiting now NA Last updated 27 June 2025

What this trial tests

NA trial testing Endo-epicardial ablation in Ischemic Cardiomyopathy in 150 participants. Currently enrolling.

Timeline

23 October 2023

Primary endpoint
23 October 2029

23 October 2029

Quick facts

Lead sponsor	Rennes University Hospital
Phase	NA
Status	Recruiting now
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	none
Primary purpose	treatment
Enrollment	150
Start date	23 October 2023
Primary completion	23 October 2029
Estimated completion	23 October 2029
Sites	12 locations across France

Drugs / interventions tested

• Endo-epicardial ablation
• endocardial ablation only

Conditions studied

• Ischemic Cardiomyopathy — all drugs for Ischemic Cardiomyopathy →
• Catheter Ablation of Ventricular Tachycardia — all drugs for Catheter Ablation of Ventricular Tachycardia →

Sponsor

Rennes University Hospital

Who can join

18 and older, any sex, with Ischemic Cardiomyopathy or Catheter Ablation of Ventricular Tachycardia. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Radiofrequency ablation of ventricular tachycardias (VTs) is the gold standard treatment of refractory VTs in patients with ischaemic heart disease. In this setting, ablation is usually performed endocardially. However, even after a procedural success there is a high risk of recurrence, particularly due to the inability to create transmural lesions. Indeed, only the endocardium of the LV has been ablated, while a significant part of the arrhythmia substrate may be located on the other side of the myocardial thickness, on the epicardial side of the LV.

First described in 1996, epicardial ablation, performed via a percutaneous subxyphoid approach, has since undergone considerable development. Electrophysiologists often use a double endo- and epicardial approach as first line therapy for the ablation of VTs complicating myocarditis or arrhythmogenic dysplasia of the right ventricle, where the substrate is most often epicardial.

For VT in ischaemic heart disease, electrophysiologists perform endocardial ablation, and often perform epicardial ablation only after several endocardial failures. Several observational studies suggest that a combined endo- and epicardial approach as first line therapy is associated with a reduced risk of VT recurrence. Since recurrent VT in patients with ischaemic heart disease as a prognostic impact in terms of morbidity and mortality, it appears essential to optimise rhythm management by ablation, by offering a combined approach from the as first approach to reduce the risk of recurrences.

The aim of our prospective, multicentre, controlled, randomized study is therefore to compare the rate of VT recurrence after ablation performed as first line therapy either by endocardial approach alone or by combined endo-epicardial approach.

Publications & conference data

No peer-reviewed publications indexed yet for this trial.