Open-chest hybrid epicardial mapping and ablation during LVAD implantation achieved acute procedural success in 60% (3 of 5) of patients with recurrent ventricular tachycardia.
Observational (n=5)
Does open chest epicardial mapping and ablation reduce recurrent ventricular tachycardia in patients with end-stage heart failure undergoing LVAD implantation?
Open-chest hybrid epicardial mapping and ablation for recurrent VT is feasible and can effectively reduce VT burden when performed concomitantly with LVAD implantation.
INTRODUCTION: Patients undergoing catheter ablation for ventricular tachycardia (VT) may require epicardial mapping. In patients with end-stage heart failure, hybrid surgical epicardial mapping and ablation during the period of left ventricular assist device (LVAD) implantation may be considered in select patients to reduce post-LVAD ventricular tachycardia. METHODS AND RESULTS: From March 2009 to October 2012, 5 patients (4 men and 1 woman, age range 52-73 years) underwent open chest electrophysiology study and epicardial mapping for recurrent ventricular tachycardia while the heart was exposed during the period of LVAD implantation. Epicardial mapping was considered if patients had recurrent VT despite failed prior endocardial ablation and/or electrocardiogram (EKG) features of an epicardial exit. Activation and/or a substrate mapping approach were employed during all procedures. Three of 5 patients (60%) had acute procedural success. In all patients, VT was either eliminated or significantly reduced with epicardial ablation. One patient had mediastinal bleeding delaying sternal closure. During a follow-up period of 363 ± 368 days, 4 patients died due to nonarrhythmic causes. CONCLUSIONS: Open-chest hybrid epicardial mapping and ablation for recurrent VT is feasible and can be considered in select patients during the period of LVAD implantation.
Patel et al. (Thu,) conducted a observational in Recurrent ventricular tachycardia (n=5). Open chest epicardial mapping and ablation was evaluated on Acute procedural success. Open-chest hybrid epicardial mapping and ablation during LVAD implantation achieved acute procedural success in 60% (3 of 5) of patients with recurrent ventricular tachycardia.