Remote magnetic navigation–guided ventricular tachycardia ablation with continuous-flow mechanical circulatory support

Figures

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  Figure 1. Several procedural recordings from the remote magnetic navigation–guided ventricular tachycardia (VT) ablation procedure. A: Fluoroscopic image of the Impella (Abiomed Inc, Danvers, MA) and catheters in the right anterior oblique (RAO) view. B: Intracardiac electrogram of a VT with a cycle length of 300 ms recorded during ablation. C: Surface electrocardiogram (ECG) and mean arterial pressure (MAP) curve showing induction of VT. The pulsatile MAP curve changes into a flat curve around 60 mm Hg because of the hemodynamic support provided by the Impella. D: Surface ECG and MAP recorded a few minutes later. MAP remains constant around 60 mm Hg during sustained VT. E: Image of the CARTO map (Biosense Webster, Diamond Bar, CA). All ablation points on the anterior wall of the left ventricle are visualized. ICD = implantable cardioverter–defibrillator; RA = right atrium; RF = radiofrequency; RV = right ventricle.

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  Figure 2. Schematic posteroanterior overview of positioning of the Impella CP continuous-flow mechanical circulatory support device (Abiomed Inc, Danvers, MA) and the CARTO patches (Biosense Webster, Diamond Bar, CA). The CARTO patches were positioned anterior and posterior on the chest and back of the patient so that the Impella CP motor was lying as far out of their field as possible. A = anterior; P = posterior.