Comparing two heart ablation approaches for dangerous fast heartbeats after heart attack damage
Compares inner-only ablation with inner plus outer ablation for ventricular tachycardia in ischemic cardiomyopathy.
Key facts
- Who runs it
- Rennes University Hospital
- Where
- Bordeaux, Caen, Clermont-Ferrand, Lille, Lyon, Nantes, Paris, Rennes, Saint-Etienne, Toulouse, and Tours, FranceSee the 12 sites
- Trial code
- Registry title
- Endo-epicardial vs Endocardial-only Catheter Ablation of Ventricular Tachycardia in Patients With Ischemic Cardiomyopathy (EPIC-VT)
- Status
- Recruiting
- People taking part
- 150 people, planned
- Started
- 23 Oct 2023
- Expected to end
- 23 Oct 2029
- Type of study
- Interventional, 2 groupsOne group gets an existing treatment, for comparison.
- Treatments tested
- Endo-epicardial ablation
- endocardial ablation only
- Record updated
- 27 June 2025
Who can take part
AI summary
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with heart disease caused by poor blood flow (ischaemic heart disease) who are having their first ablation for ventricular tachycardia, a fast heart rhythm. It compares ablation from inside the heart only with ablation from both inside and outside the heart.
- Age
- Over 18 years.
- Sex
- All sexes can join.
- Disease stage
- Ventricular tachycardia caused by ischaemic heart disease, with a first radiofrequency ablation planned.
- Earlier treatment
- People must already have an ICD (implanted defibrillator) with remote monitoring. This must be their first ablation for ventricular tachycardia.
Main reasons for not taking part
- Past heart surgery that may block access to the outer heart surface, such as bypass or valve replacement
- Blood clot inside the left heart chamber seen on imaging before the procedure
- Blood thinners that cannot be stopped for a short time, or double antiplatelet therapy that cannot be reduced to one drug
- Past pericarditis, past chest radiotherapy, or past heparin-induced thrombocytopenia type 2
- Pregnant or breastfeeding women, or people who cannot have general anaesthesia
The registry criteria, word for word
Show all 16 criteriaShow less
Who can take part
- Patients over 18 years of age
- 1st radiofrequency ablation of VT complicating ischaemic heart disease
- Patients with an ICD and remote monitoring
- Having, for women of childbearing age, effective contraception until discharge from hospital
- Have given their free and informed consent in writing
- are affiliated to or have health insurance
Who cannot take part
- Anticoagulant therapy that cannot be temporarily discontinued
- Double antiplatelet therapy that cannot be temporarily replaced by single antiplatelet therapy
- Previous thoracic radiotherapy
- History of cardiac surgery compromising the epicardial approach (coronary artery bypass grafting, valve replacements, or other surgeries that may have caused pericardial adhesions)
- History of pericarditis
- History of heparin-induced thrombocytopenia type 2 (as injection is required during the procedure)
- Presence of a left intraventricular thrombus found during pre-procedure imaging
- Contraindication to general anaesthesia
- Pregnant or breastfeeding woman
- Person under legal protection (safeguard of justice, curatorship, guardianship), deprived of liberty, or unable to express consent
Where in France
- CHU de BordeauxBordeaux, FranceContact: Frédéric SACHERNot yet recruiting
- Centre Hospitalier Universitaire de CaenCaen, FranceContact: Laure CHAMP RIGOTNot yet recruiting
- Centre Hospitalier de Clermont-FerrandClermont-Ferrand, FranceContact: Grégoire MASSOUILLIETaking people
- Centre Hospitalier Regional Universitaire de LilleLille, FranceContact: François BRIGADEAUNot yet recruiting
- Hospices Civils de LyonLyon, FranceContact: Françis BESSIERENot yet recruiting
- CHU de NantesNantes, FranceContact: Jean-Baptiste GOURRAUDTaking people
- Hôpital Européen Georges PompidouParis, FranceContact: Emilie VARLETTaking people
- Hôpital Universitaire La Pitié-Salpêtrière - ParisParis, FranceContact: Xavier WAINTRAUBNot yet recruiting
- CHU de RennesRennes, FranceContact: Raphaël MARTINSTaking people
- Centre Hospitalier Universitaire de Saint EtienneSaint-Etienne, FranceContact: Karim BENALINot yet recruiting
- Centre Hospitalier Universitaire Toulouse - Hôtel Dieu Saint-JacquesToulouse, FranceContact: Jean-Philippe MAURYNot yet recruiting
- Centre Hospitalier Régional Universitaire Tours - Hôpital BretonneauTours, FranceContact: Bertrand PIERRENot yet recruiting
About the trial
What the trial wants to find out
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.
Read full original descriptionShow less
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.
The 2 groups in the trial
- Endo-epicardial ablationTreatment being tested
- endocardial ablation onlyExisting treatment, for comparison
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorData and sources
- Registry record
- Listed on ClinicalTrials.gov.
- Official title
- Endo-epicardial vs Endocardial-only Catheter Ablation of Ventricular Tachycardia in Patients Withischemic Cardiomyopathy: a Randomized Controlled Study
- Plain-language title
- Comparing two heart ablation approaches for dangerous fast heartbeats after heart attack damageGenerated from the registry record. The registry title is the official one.
- AI summary
- From the trial's eligibility criteria. Read by machine on 14 November 2026.
- Record updated
- 27 June 2025