Characteristics of ventricular tachycardia ablation in patients with continuous flow left ventricular assist devices
Language English Country United States Media print-electronic
Document type Journal Article, Observational Study
PubMed
25870335
DOI
10.1161/circep.114.002394
PII: CIRCEP.114.002394
Knihovny.cz E-resources
- Keywords
- ablation, ventricular arrhythmia, ventricular assist device, ventricular tachycardia,
- MeSH
- Action Potentials MeSH
- Time Factors MeSH
- Tertiary Care Centers MeSH
- Electrophysiologic Techniques, Cardiac MeSH
- Ventricular Function, Left * MeSH
- Catheter Ablation * MeSH
- Tachycardia, Ventricular diagnosis mortality physiopathology surgery MeSH
- Middle Aged MeSH
- Humans MeSH
- Heart-Assist Devices * adverse effects MeSH
- Recurrence MeSH
- Risk Factors MeSH
- Aged MeSH
- Heart Failure diagnosis mortality physiopathology therapy MeSH
- Feasibility Studies MeSH
- Stroke Volume MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Geographicals
- Europe MeSH
- United States MeSH
BACKGROUND: Left ventricular assist devices (LVADs) are increasingly used as a bridge to cardiac transplantation or as destination therapy. Patients with LVADs are at high risk for ventricular arrhythmias. This study describes ventricular arrhythmia characteristics and ablation in patients implanted with a Heart Mate II device. METHODS AND RESULTS: All patients with a Heart Mate II device who underwent ventricular arrhythmia catheter ablation at 9 tertiary centers were included. Thirty-four patients (30 male, age 58±10 years) underwent 39 ablation procedures. The underlying cardiomyopathy pathogenesis was ischemic in 21 and nonischemic in 13 patients with a mean left ventricular ejection fraction of 17%±5% before LVAD implantation. One hundred and ten ventricular tachycardias (VTs; cycle lengths, 230-740 ms, arrhythmic storm n=28) and 2 ventricular fibrillation triggers were targeted (25 transseptal, 14 retrograde aortic approaches). Nine patients required VT ablation <1 month after LVAD implantation because of intractable VT. Only 10/110 (9%) of the targeted VTs were related to the Heart Mate II cannula. During follow-up, 7 patients were transplanted and 10 died. Of the remaining 17 patients, 13 were arrhythmia-free at 25±15 months. In 1 patient with VT recurrence, change of turbine speed from 9400 to 9000 rpm extinguished VT. CONCLUSIONS: Catheter ablation of VT among LVAD recipients is feasible and reasonably safe even soon after LVAD implantation. Intrinsic myocardial scar, rather than the apical cannula, seems to be the dominant substrate.
References provided by Crossref.org
Percutaneous mechanical support in catheter ablation of ventricular arrhythmias: hype or hope?
Management of ventricular arrhythmias in heart failure: Current perspectives
2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias
2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias
2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias