Highlights the growing interest and challenges in substrate-based mapping and ablation of epicardial ventricular tachycardia during LVAD implantation.
Patients with end-stage cardiomyopathy undergoing left ventricular assist device (LVAD) implant frequently exhibit high-epicardial scar burden that correlates with the risk of postimplant ventricular arrhythmias.1 Radiofrequency (RF) ablation of critical circuit components via a percutaneous subxyphoid approach2 improves freedom from ventricular arrhythmias3,4 but is complicated in patients post-LVAD owing to difficulty accessing the pericardium. Mapping and ablation of arrhythmia circuits during LVAD implant is an area of growing interest; however, substrate-based methods for identifying critical ventricular tachycardia (VT) circuits in this setting are not well defined.
Kushnir et al. (Sat,) studied this question.
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