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April 25, 2023CureusOpen Access

Extracorporeal Membrane Oxygenation-Impella (ECPELLA) in a Patient With Recalcitrant Ventricular Tachycardia Undergoing Ablation

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Population

1 patient with recalcitrant hemodynamically unstable VT complicated by cardiac arrest

Comparison

VT ablation supported by VA ECMO and Impella 5.5 in ECPELLA configuration

Design

Case report

Authors

KRKripa RajakSUNY Upstate Medical UniversityAHAnupam HalderIndian Institute of Technology KanpurSPSmit PaghdarJacksonville College

Discussion

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Implication

May support MCS escalation in refractory VT; leaves open prospective outcome data before broader adoption.

Structured PICO

P
Population
1 63-year-old male with nonischemic cardiomyopathy, LVEF 10%, dual chamber ICD, and recalcitrant hemodynamically unstable ventricular tachycardia.
I
Intervention
Ventricular tachycardia ablation supported by veno-arterial extracorporeal membrane oxygenation (VA ECMO) and Impella 5.5 as a left ventricular vent (ECPELLA configuration).

ECPELLA (VA ECMO plus Impella 5.5) can provide escalated mechanical circulatory support for patients with refractory cardiogenic shock undergoing high-risk VT ablation, though overall prognosis in such extreme cases may remain poor.

Cite This Study

Rajak et al. (2023) studied this question.

synapsesocial.com/papers/6a6f6628febe604dd7085311https://doi.org/10.7759/cureus.38114
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Also Consider

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  1. 1Efficacy and safety of ventricular tachycardia ablation with mechanical circulatory support compared with substrate-based ablation techniques2011 · 68 citations
  2. 2Management of Pediatric Tachyarrhythmias on Mechanical Support2014 · 33 citations
  3. 3Long-Term Success of Irrigated Radiofrequency Catheter Ablation of Sustained Ventricular Tachycardia2016 · 153 citations
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  5. 5Catheter Ablation in Patients With Cardiogenic Shock and Refractory Ventricular Tachycardia2020 · 29 citations