Advanced Electroanatomic Mapping with the TriDeca™ Catheter in Left Ventricular Assist Device-associated Ventricular Tachycardia: A Report of Two Cases.

Figures

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  Figure 1:. Fluoroscopic view of catheters for case 1. Note that the TriDeca™ catheter is curled in a fashion to prevent suctioning into the left ventricular assist device inflow. Abbreviations: LVAD, left ventricular assist device.

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  Figure 2:. Left ventricular mapping for case 1.

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  Figure 3:. Intracardiac echocardiography image demonstrating the ablation catheter tip positioned adjacent to the left ventricular assist device inflow cannula within the left ventricle. Abbreviation: LVAD, left ventricular assist device.

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  Figure 4:. Left ventricular mapping for case 2. A: Three-dimensional Left ventricle electroanatomic map in the HeartMate 3™ left ventricular assist device recipient (case 2), demonstrating overall left ventricular geometry and cannula position. High-density mapping with the linear TriDeca™ catheter defines the cannula-adjacent substrate and areas of low voltage/late activation in the basal and mid-ventricle. Surface electrocardiogram leads and intracardiac electrograms from the mapping and ablation catheters are displayed on the right. B: Local activation time isochronal map acquired with the TriDeca™ catheter and ablation catheter during induced monomorphic VT (CL, 359 ms). Isochronal crowding within the cannula-adjacent inferoseptal region highlights a slow conduction channel that was targeted for ablation. The ablation catheter is positioned at this late activation site, and representative electrograms from the same region are shown on the right. C: Local activation time isochronal map isochronal map recorded during the same VT (CL, 325 ms) demonstrating combined mapping with the Advisor™ HD Grid and TriDeca™ catheters around the left ventricular assist device inflow cannula. The HD Grid…