Figure 6. Lesion morphology and histological examination in ethanol ablated animal model. A: with increasing dose of ethanol (0.2, 0.3, 0.5ml), the lesion size increased correspondingly (8, 10, 12mm respectively). B: acute necrosis of the myocardium could be seen immediately after ethanol injection (HE×100). C: the chronic lesion was homogeneous with clear border (Masson’s×10).
Graphic abstract: Surgical Epicardial Ablation Supplemented by Ethanol Injection for Ventricular Tachycardia Refractory to Percutaneous ablation. A: Energy penetration is insufficient by endocardial ablation to reach the critical tissue maintaining ventricular tachycardia. B: Percutaneous epicardial ablation is an alternative approach but is still not enough to touch the foci due to poor contact force and epicardial fat tissue. C: Direct epicardial ablation via surgical approach could make deeper lesions with increased contact force. D: Intramural ethanol injection could produce deep and homogenous lesions with clear boundary.