Impacts of Hemodynamic Support on Ventricular Arrhythmia Ablation

Figures

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  Figure 1. Patients. Consecutive HF patients undergoing ventricular arrhythmia ablation were divided into four groups allowing for a direct comparison of advanced HF patients (groups I + III) to patients without advanced HF (groups II + IV) and patients with HS (groups I + II) to those without (groups III + IV). Beyond that, the cohort of patients with advanced HF and HS (group III) was compared to patients with advanced HF that did not require HS (group I). HF, heart failure; HS, hemodynamic support.

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  Figure 2. Representative images of ventricular arrhythmia ablation with HS with (A) ECMO, (B) Impella, and (C) LVAD. AC, ablation catheter; CS, coronary sinus; ECMO, extracorporeal membrane oxygenation; HS, hemodynamic support; LVAD, left ventricular assist device; RVa, right ventricle apex; VA, ventricular arrhythmia.

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  Figure 3. (a) Kaplan–Meier plot analyses on 24‐month VA‐free survival. (A) Patients with advanced HF presented with a significantly lower VA‐free survival rate compared to those without. (B) Patients with pre‐emptive HS showed a higher VA‐recurrence rate compared to the group of patients without HS. (C) HS with an ECMO and LVAD, but not with an Impella, was associated with a significantly lower VA‐free survival rate in contrast to patients without HS. (D) Subgroup analyses of patients with advanced HF compared to those with advanced HF that had required HS additionally, revealed a significantly higher VA‐recurrence rate in the latter. (b) CIF of VA recurrence accounting for the competing risk of death, analyzed using Fine and Gray SHR. Advanced HF (A), pre‐emptive HS (B), and HS with an ECMO (C) or LVAD (D) were associated with a significantly increased risk of VA recurrence, whereas Impella support (E) was not associated with a statistically significant increase in VA recurrence. CIF, cumulative incidence function; ECMO, extracorporeal membrane oxygenation; HF, heart failure; HS, hemodynamic support; LVAD, left ventricular assist device; SHR, subdistribution hazard model; VA, ventricular…

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  Figure 4. Kaplan–Meier plot analyses on 24‐month mortality. (A) Patients with advanced HF presented with a significantly higher mortality rate compared to those without. (B) Patients with pre‐emptive HS showed a higher mortality compared to the group of patients without HS. (C) HS with an ECMO and LVAD, but not with an Impella, was associated with a significantly higher mortality in contrast to patients without HS. (D) Subgroup analyses of patients with advanced HF compared to those with advanced HF that had required HS additionally, revealed a significantly higher mortality in the latter. ECMO, extracorporeal membrane oxygenation; HF, heart failure; HS, hemodynamic support; LVAD, left ventricular assist device; VA, ventricular arrhythmia.