Percutaneous endocardial and epicardial ablation of hypotensive ventricular tachycardia with percutaneous left ventricular assist in the electrophysiology laboratory.
Ventricular tachycardia (VT) in the setting of structural heart disease is challenging to treat with percutaneous catheter ablation due to the presence of complex substrate, multiple morphologies, hemodynamic instability, and epicardial circuits. When substrate-based approaches fail, however, it may be impossible to map and ablate hemodynamically unstable arrhythmias. We describe a novel approach to endocardial and epicardial mapping and ablation of hypotensive VT using a percutaneous left ventricular assist device in the electrophysiology laboratory, permitting near-surgical access to cardiac structures.
Friedman
Paul A
PA
Division of Cardiovascular Medicine and the Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA. pfriedman@mayo.edu
Munger
Thomas M
TM
Torres
Norman
N
Rihal
Charanjit
C
D001243:Assisted Circulation / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D006339:Heart Rate / Q000502:physiology; D006353:Heart-Assist Devices; D006801:Humans; D007022:Hypotension / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000150:complications / Q000503:physiopathology / Q000601:surgery*