Highlights the potential need for external hemodynamic support such as TandemHeart during VT ablation in patients with severe heart failure.
Does not support routine TandemHeart use; leaves open its role in severe-HF VT ablation pending prospective data.
Ventricular tachycardia (VT) is common in patients with advanced heart failure, and medical therapy alone may have limited success. Implantable cardioverter defibrillators (ICDs) have been widely accepted as standard of care for VT management and prevention of sudden cardiac death. However, this therapy does not in itself reduce episodes of clinical VT. For patients who do not respond well to medical therapy, percutaneous catheter ablation has been shown to reduce episodes of recurrent VT.1 However, patients undergoing catheter ablation with a severely decreased left ventricular ejection fraction (LVEF) may experience hemodynamic instability during the ablation procedure, requiring external hemodynamic support.
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Miller et al. (2015) studied this question.
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