A majority of patients with structural heart disease and scar-related ventricular
tachycardia (VT) have fast, hemodynamically unstable VT.
1
In fact, up to one-fifth of the patients have only unstable VT, which precludes detailed
activation and entrainment mapping.
2
In addition, even in those with well-tolerated VT, procedural success can be complicated
by acute heart failure as a consequence of prolonged episodes of induced VT and intravascular
volume expansion; and one consequence of this acute decompensated heart failure is
a significant increase in the short-term morbidity and mortality of the procedure.
3
,
- Aliot E.M.
- Stevenson W.G.
- Almendral-Garrote J.M.
- et al.
EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias: developed
in a partnership with the European Heart Rhythm Association (EHRA), a registered branch
of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in
collaboration with the American College of Cardiology (ACC) and the American Heart
Association (AHA).
Heart Rhythm. 2009; 6: 886-933
4
In an attempt to maintain organ perfusion (hemodynamic stability) to allow detailed
mapping of VT and to minimize postprocedure acute heart failure by unloading the left
ventricle (LV), there has been an increased interest in using temporary mechanical
cardiac support in the electrophysiology laboratory.Keywords
Abbreviations:
ACT (activated clotting time), CFA (common femoral artery), EMI (electromagnetic interference), LV (left ventricle/left ventricular), pLVAD (percutaneous left ventricular assist device), RV (right ventricular), VT (ventricular tachycardia)To read this article in full you will need to make a payment
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References
- Catheter ablation of recurrent scar-related ventricular tachycardia using electroanatomical mapping and irrigated ablation technology: results of the prospective multicenter Euro-VT-study.J Cardiovasc Electrophysiol. 2010; 21: 47-53
- Ventricular tachycardia ablation: evolution of patients and procedures over 8 years.Circ Arrhythm Electrophysiol. 2008; 1: 153-161
- EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias: developed in a partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA).Heart Rhythm. 2009; 6: 886-933
- Assessing patients for catheter ablation during hospitalization for acute heart failure.Heart Fail Rev. 2011; 16: 467-476
- Activation and entrainment mapping of hemodynamically unstable ventricular tachycardia using a percutaneous left ventricular assist device.J Am Coll Cardiol. 2011; 58: 1363-1371
- Efficacy and safety of ventricular tachycardia ablation with mechanical circulatory support compared with substrate-based ablation techniques.Europace. 2011; https://doi.org/10.1093/europace/eur347
- Novel percutaneous cardiac assist devices: the science of and indications for hemodynamic support.Circulation. 2011; 123: 533-543
- 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions.J Am Coll Cardiol. 2011; 58: e44-e122
- Effects of left ventricular unloading by Impella recover LP2.5 on coronary hemodynamics.Catheter Cardiovasc Interv. 2007; 70: 532-537
- Characterization of the arrhythmogenic substrate in ischemic and nonischemic cardiomyopathy implications for catheter ablation of hemodynamically unstable ventricular tachycardia.J Am Coll Cardiol. 2010; 55: 2355-2365
- Catheter ablation for the treatment of electrical storm in patients with implantable cardioverter-defibrillators: short- and long-term outcomes in a prospective single-center study.Circulation. 2008; 117: 462-469
- Sympathetic neural responses to induced ventricular tachycardia.J Am Coll Cardiol. 1991; 18: 1015-1024
- Percutaneous left ventricular assist devices: clinical uses, future applications, and anesthetic considerations.J Cardiothorac Vasc Anesth. 2010; 24: 478-486
- Perioperative echocardiographic examination for ventricular assist device implantation.Anesth Analg. 2007; 105: 583-601
- Vascular closure devices: the second decade.J Am Coll Cardiol. 2007; 50: 1617-1626
- Large calibre arterial access device closure for percutaneous aortic valve interventions: use of the prostar system in 118 cases.Catheter Cardiovasc Interv. 2011; 79: 143-149
- Pre-closure of femoral venous access sites used for large-sized sheath insertion with the Perclose device in adults undergoing cardiac intervention.Heart. 2008; 94: 571-572
- The use of percutaneous suture-mediated closure for the management of 14 French femoral venous access.J Invasive Cardiol. 2006; 18: 299-302
- Epicardial ablation for ventricular tachycardia: a European multicenter study.Circ Arrhythm Electrophysiol. 2011; 4: 653-659
- Chronic nonpulsatile blood flow is compatible with normal end-organ function: implications for LVAD development.J Artif Organs. 2005; 8: 143-148
- The relationship between blood pressure and cognitive function.Nat Rev Cardiol. 2010; 7: 686-698
- Effect of phenylephrine and ephedrine bolus treatment on cerebral oxygenation in anaesthetized patients.Br J Anaesth. 2011; 107: 209-217
- Recent advances in application of cerebral oximetry in adult cardiovascular surgery.Semin Cardiothorac Vasc Anesth. 2008; 12: 60-69
- Noninvasive cerebral oximetry: is there light at the end of the tunnel?.Curr Opin Anaesthesiol. 2010; 23: 576-581
- A comparison of cerebral oxygenation as measured by the NIRO 300 and the INVOS 5100 Near-Infrared Spectrophotometers.Anaesthesia. 2002; 57: 999-1006
- Baseline regional cerebral oxygen saturation correlates with left ventricular systolic and diastolic function.J Cardiothorac Vasc Anesth. 2008; 22: 840-846
- Preoperative cerebral oxygen saturation and clinical outcomes in cardiac surgery.Anesthesiology. 2011; 114: 58-69
- Determinants of cerebral oximetry in patients undergoing off-pump coronary artery bypass grafting: an observational study.Eur J Anaesthesiol. 2010; 27: 542-549
Article info
Publication history
Published online: February 10, 2012
Footnotes
Dr Miller, Dr d'Avila, and Dr Reddy received speaker honoraria from ABIOMED, the manufacturer of the percutaneous left ventricular assist device discussed in this article. Dr Reddy received grant support from ABIOMED. Dr d'Avila and Dr Reddy received consulting fees from Biosense Webster, the manufacturer of the electroanatomic mapping system depicted and discussed in this article.
Identification
Copyright
© 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
