title: Endocardial catheter ablation of ventricular tachycardia in patients with ventricular assist devices.
abstract: BACKGROUND
  The outcomes of patients with ventricular assist devices (VADs) who undergo catheter ablation for ventricular tachycardia (VT) have not been reported.
  
  
  OBJECTIVE
  The purpose of this study was to assess the feasibility, safety, and efficacy of endocardial VT ablation in patients with VADs.
  
  
  METHODS
  We retrospectively reviewed three cases at our institution where endocardial catheter ablation was performed in patients with VADs and incessant VT.
  
  
  RESULTS
  Three patients with underlying cardiomyopathies and VADs underwent VT ablation for incessant VT refractory to multiple antiarrhythmic medications. In each case, VT was either eliminated or significantly ameliorated by catheter ablation. No procedure-related complications occurred. The hemodynamic stability afforded by the VAD played an important role in facilitating ablation in two of the cases.
  
  
  CONCLUSIONS
  Catheter ablation for VT in VAD patients appears to be feasible, safe, and effective based on our initial experience. Several technical issues, such as decreases in ventricular volumes that can limit maneuverability of the ablation catheter and potential entrapment of the mapping catheter in the inflow cannula, need to be considered at the time of ablation.
authors.affiliation: Krannert Institute of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202-1228, USA.
authors.forename: Gopi
authors.initials: G
authors.lastname: Dandamudi
authors.forename: Waqas S
authors.initials: WS
authors.lastname: Ghumman
authors.forename: Mithilesh K
authors.initials: MK
authors.lastname: Das
authors.forename: John M
authors.initials: JM
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D002306:Cardiac Volume; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography; D017809:Fatal Outcome; D005240:Feasibility Studies; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome