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Pericardial adhesions can prevent epicardial access and restrict catheter movement during mapping and ablation of ventricular tachycardia (VT). The incidence of adhesions in patients without prior cardiac surgery or clinically evident pericarditis is not known.

To describe the incidence of pericardial adhesions and explore their impact in patients without prior cardiac surgery or pericarditis.

A retrospective search of our ablation database containing patients who underwent epicardial ablation for VT was undertaken. Adhesions were diagnosed with routine contrast pericardiography after pericardial entry. Demographics and long-term outcomes were compared between patients with and without adhesions.

Between 2004 and 2016, successful epicardial entry was achieved in 188 of 192 attempts (98%). In 155 first-time epicardial access attempts, pericardial adhesions were …