Percutaneous right ventricular assist device–supported ventricular tachycardia ablation in a patient with severe right ventricular dysfunction

Figures

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  Figure 1. A: Echocardiographic short-axis view at end-diastole demonstrating severe right ventricle (RV) dilatation with flattening of the interventricular septum and normal left ventricular dimensions. B: Computerized tomographic 4-chamber view demonstrating severe right atrial (RA) dilatation, a prominent moderator band (arrowheads), and the entire apex taken up by the RV. C: CXR demonstrating the position of the Protek Duo cannula (LivaNova, London, UK) (black arrowheads), RA inflow port (blue arrowhead), and pulmonary artery outflow port (red arrowhead).

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  Figure 2. A: A 12-lead electrocardiogram of the patient’s clinical tachycardia at a cycle length of 590 ms with left bundle/inferior axis configuration. B: Intraprocedural recording showing entrainment with concealed fusion for the clinical ventricular tachycardia; the arterial line tracing demonstrates stable blood pressure during tachycardia.

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  Figure 3. A: Left anterior oblique (LAO) view of the right ventricle voltage map demonstrating areas of low voltage around the tricuspid annulus (red) and the sites of successful ablation. B: The 12-lead configuration of the 3 tachycardias (VT1–VT3) targeted for ablation with arterial blood pressure (ABP) tracings.