Cardiopulmonary support with ECMO during catheter ablation for electrical storm resulted in a 68% overall procedural success rate and 84% VT non-inducibility.
Observational (n=19)
No
Does extracorporeal membrane oxygenation (ECMO) support improve procedural success and safety during catheter ablation in patients with electrical storm?
ECMO support is a feasible strategy to facilitate catheter ablation in high-risk patients presenting with electrical storm, achieving high rates of acute procedural success.
INTRODUCTION: Catheter ablation is an important treatment option for sustained ventricular arrhythmias (VA) that are refractory to pharmacological treatment; however, patients with fast VA or electrical storm (ES) are at risk for cardiogenic shock. We report our experience using cardiopulmonary support with extracorporeal membrane oxygenation (ECMO) during catheter ablation of VA. METHODS: Nineteen patients (mean age, 62 ± 10 years; 84% male) were referred to our center for CA of ES between January 2017 and April 2018. ES was defined as the occurrence of ≥3 ventricular tachycardia or ventricular fibrillation episodes requiring electrical cardioversion or defibrillation in a 24-hour period. ECMO support was implemented for all patients. RESULTS: CA of ES was completed in all patients. Activation mapping was performed for all VTs and substrate modification was performed by targeting sites identified by late/fragmented abnormal potentials. VTs were not inducible after ablation in 16 of 19 patients (84%). With regard to procedural complications, two patients underwent percutaneous angioplasty with stenting for a femoral artery dissection and one patient was treated for a dislodged ECMO arterial cannula and subsequent hemorrhagic shock. After a median follow-up of 10 months, three patients died from refractory heart failure and one patient died as a result of ES. Overall, the procedural success rate was 68% and the Kaplan-Meier mortality rate was 21%. CONCLUSIONS: ECMO support may be used for ablation procedures in patients with ES.
Monaco et al. (Tue,) conducted a observational in Electrical storm and poorly tolerated ventricular arrhythmias (n=19). Cardiopulmonary support with extracorporeal membrane oxygenation (ECMO) was evaluated on Overall procedural success. Cardiopulmonary support with ECMO during catheter ablation for electrical storm resulted in a 68% overall procedural success rate and 84% VT non-inducibility.