TY - JOUR
T1 - Outcomes of pre-emptive and rescue use of percutaneous left ventricular assist device in patients with structural heart disease undergoing catheter ablation of ventricular tachycardia
AU - Mathuria, Nilesh
AU - Wu, Geru
AU - Rojas-Delgado, Francia
AU - Shuraih, Mossaab
AU - Razavi, Mehdi
AU - Civitello, Andrew
AU - Simpson, Leo
AU - Silva, Guilherme
AU - Wang, Suwei
AU - Elayda, MacArthur A.
AU - Kantharia, Bharat
AU - Singh, Steve
AU - Frazier, O. H.
AU - Cheng, Jie
N1 - Publisher Copyright:
© 2016, Springer Science+Business Media New York.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Purpose: Patient selection and timing of percutaneous left ventricular assist device (pLVAD) insertion for maximal benefit during ventricular tachycardia (VT) ablation is not well defined. We aimed to assess the outcomes of pre-emptive and rescue use of pLVAD during VT ablation in patients with ischemic and non-ischemic cardiomyopathy. Methods: Between January 2009 and October 2011, 93 patients underwent VT ablation. Three groups were compared: (1) Rescue group (n = 12)—patients who required emergent pLVAD insertion due to hemodynamic collapse during VT ablation, (2) Pre-emptive group (n = 24)—patients who had pre-ablation pLVAD insertion, and (3) Non-pLVAD group (n = 57)—patients who did not undergo pLVAD insertion. Procedural outcomes including 30-day mortality were compared. Results: Thirty-day mortality was higher in the Rescue group compared to the Pre-emptive group (58 vs. 4 %, p = 0.003) and non-pLVAD (58 vs. 3 %, p = 0.001) group. There was no significant difference in 30-day mortality or long-term freedom of VT between the pre-emptive and non-pLVAD groups. Conclusions: Despite rescue pLVAD insertion, hemodynamic collapse during VT ablation is associated with a persistently high 30-day mortality. Further studies are warranted to predict hemodynamic collapse and to refine the role of pLVAD in this setting.
AB - Purpose: Patient selection and timing of percutaneous left ventricular assist device (pLVAD) insertion for maximal benefit during ventricular tachycardia (VT) ablation is not well defined. We aimed to assess the outcomes of pre-emptive and rescue use of pLVAD during VT ablation in patients with ischemic and non-ischemic cardiomyopathy. Methods: Between January 2009 and October 2011, 93 patients underwent VT ablation. Three groups were compared: (1) Rescue group (n = 12)—patients who required emergent pLVAD insertion due to hemodynamic collapse during VT ablation, (2) Pre-emptive group (n = 24)—patients who had pre-ablation pLVAD insertion, and (3) Non-pLVAD group (n = 57)—patients who did not undergo pLVAD insertion. Procedural outcomes including 30-day mortality were compared. Results: Thirty-day mortality was higher in the Rescue group compared to the Pre-emptive group (58 vs. 4 %, p = 0.003) and non-pLVAD (58 vs. 3 %, p = 0.001) group. There was no significant difference in 30-day mortality or long-term freedom of VT between the pre-emptive and non-pLVAD groups. Conclusions: Despite rescue pLVAD insertion, hemodynamic collapse during VT ablation is associated with a persistently high 30-day mortality. Further studies are warranted to predict hemodynamic collapse and to refine the role of pLVAD in this setting.
KW - Ablation
KW - Cardiomyopathy
KW - Percutaneous left ventricular assist device
KW - Ventricular tachycardia
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U2 - 10.1007/s10840-016-0168-8
DO - 10.1007/s10840-016-0168-8
M3 - Article
C2 - 27497847
AN - SCOPUS:84982976327
SN - 1383-875X
VL - 48
SP - 27
EP - 34
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
IS - 1
ER -