Safety and Feasibility of Open Chest Epicardial Mapping and Ablation of Ventricular Tachycardia During the Period of Left Ventricular Assist Device Implantation.
J Cardiovasc Electrophysiol
; 27(1): 95-101, 2016 Jan.
Article
in En
| MEDLINE
| ID: mdl-26377813
ABSTRACT
INTRODUCTION:
Patients undergoing catheter ablation for ventricular tachycardia (VT) may require epicardial mapping. In patients with end-stage heart failure, hybrid surgical epicardial mapping and ablation during the period of left ventricular assist device (LVAD) implantation may be considered in select patients to reduce post-LVAD ventricular tachycardia. METHODS ANDRESULTS:
From March 2009 to October 2012, 5 patients (4 men and 1 woman, age range 52-73 years) underwent open chest electrophysiology study and epicardial mapping for recurrent ventricular tachycardia while the heart was exposed during the period of LVAD implantation. Epicardial mapping was considered if patients had recurrent VT despite failed prior endocardial ablation and/or electrocardiogram (EKG) features of an epicardial exit. Activation and/or a substrate mapping approach were employed during all procedures. Three of 5 patients (60%) had acute procedural success. In all patients, VT was either eliminated or significantly reduced with epicardial ablation. One patient had mediastinal bleeding delaying sternal closure. During a follow-up period of 363 ± 368 days, 4 patients died due to nonarrhythmic causes.CONCLUSIONS:
Open-chest hybrid epicardial mapping and ablation for recurrent VT is feasible and can be considered in select patients during the period of LVAD implantation.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Heart-Assist Devices
/
Ventricular Function, Left
/
Tachycardia, Ventricular
/
Catheter Ablation
/
Prosthesis Implantation
/
Epicardial Mapping
/
Heart Failure
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Cardiovasc Electrophysiol
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Year:
2016
Document type:
Article
Affiliation country:
Estados Unidos