Why the study?
Substrate-based methods for identifying critical ventricular tachycardia circuits during left ventricular assist device implant are not well defined.
Highlights the growing interest and challenges in substrate-based mapping and ablation of epicardial ventricular tachycardia during LVAD implantation.
Caution warranted before routine use during LVAD surgery; leaves open feasibility of combined epicardial VT ablation pending prospective data.
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.
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Kushnir et al. (2020) studied this question.
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