title: Percutaneous left ventricular assist devices in ventricular tachycardia ablation: multicenter experience.
abstract: BACKGROUND
  Data on relative safety, efficacy, and role of different percutaneous left ventricular assist devices for hemodynamic support during the ventricular tachycardia (VT) ablation procedure are limited.
  
  
  RESULTS
  We performed a multicenter, observational study from a prospective registry including all consecutive patients (N=66) undergoing VT ablation with a percutaneous left ventricular assist devices in 6 centers in the United States. Patients with intra-aortic balloon pump (IABP group; N=22) were compared with patients with either an Impella or a TandemHeart device (non-IABP group; N=44). There were no significant differences in the baseline characteristics between both the groups. In non-IABP group (1) more patients could undergo entrainment/activation mapping (82% versus 59%; P=0.046), (2) more number of unstable VTs could be mapped and ablated per patient (1.05±0.78 versus 0.32±0.48; P<0.001), (3) more number of VTs could be terminated by ablation (1.59±1.0 versus 0.91±0.81; P=0.007), and (4) fewer VTs were terminated with rescue shocks (1.9±2.2 versus 3.0±1.5; P=0.049) when compared with IABP group. Complications of the procedure trended to be more in the non-IABP group when compared with those in the IABP group (32% versus 14%; P=0.143). Intermediate term outcomes (mortality and VT recurrence) during 12±5-month follow-up were not different between both groups. Left ventricular ejection fraction ≤15% was a strong and independent predictor of in-hospital mortality (53% versus 4%; P<0.001).
  
  
  CONCLUSIONS
  Impella and TandemHeart use in VT ablation facilitates extensive activation mapping of several unstable VTs and requires fewer rescue shocks during the procedure when compared with using IABP.
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital and Medical Center, Kansas City, KS.
authors.forename: Yeruva Madhu
authors.initials: YM
authors.lastname: Reddy
authors.forename: Larry
authors.initials: L
authors.lastname: Chinitz
authors.forename: Moussa
authors.initials: M
authors.lastname: Mansour
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
authors.forename: Srijoy
authors.initials: S
authors.lastname: Mahapatra
authors.forename: Vijay
authors.initials: V
authors.lastname: Swarup
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.forename: Sudharani
authors.initials: S
authors.lastname: Bommana
authors.forename: Donita
authors.initials: D
authors.lastname: Atkins
authors.forename: Roderick
authors.initials: R
authors.lastname: Tung
authors.forename: Kalyanam
authors.initials: K
authors.lastname: Shivkumar
authors.forename: J David
authors.initials: JD
authors.lastname: Burkhardt
authors.forename: Jeremy
authors.initials: J
authors.lastname: Ruskin
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left
keywords: catheter ablation; intra-aortic balloon pumping; tachycardia, ventricular