Key result
Biventricular Impella maintains hemodynamic stability and safely reduces VT burden during ablation in severe DCM.
Why the study?
VT ablation in patients with severely impaired LV function remains challenging due to poor tolerance of mapping-induced or sustained arrhythmia, which temporary mechanical circulatory support may stabilize.
Biventricular Impella support can provide necessary hemodynamic stability for high-risk ventricular tachycardia ablation in patients with severe biventricular failure.
May enable high-risk VT ablation in biventricular failure; hypothesis-generating for prospective trials in dilated cardiomyopathy.
Ventricular tachycardia (VT) ablation in patients with severely impaired left ventricular (LV) function remains challenging because mapping often requires VT induction or sustained arrhythmia that may not be tolerated. Temporary mechanical circulatory support (tMCS) can improve procedural stability in high‐risk patients. We report a successful VT ablation in a 73‐year‐old man with non‐ischemic dilated cardiomyopathy, severe biventricular failure, and recurrent VT, performed under fully percutaneous biventricular support using Impella CP and Impella RP (Abiomed) via transfemoral access. Hemodynamic stability was achieved only after the addition of right‐sided support. The procedure reduced VT burden without device‐ or access‐related complications.
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Tydecks et al. (2026) studied this question. Biventricular Impella support, specifically requiring right-sided assistance, enabled hemodynamic stability and safely reduced ventricular tachycardia burden in severe dilated cardiomyopathy.
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