TY - JOUR
T1 - HeartMate 3
T2 - New challenges in ventricular tachycardia ablation
AU - Nof, Eyal
AU - Peichl, Petr
AU - Stojadinovic, Predrag
AU - Arceluz, Martin
AU - Maury, Philippe
AU - Katz, Moshe
AU - Tedrow, Usha B.
AU - Singh, Robin M.
AU - Narui, Ryohsuke
AU - John, Roy M.
AU - Stevenson, William G.
AU - Beinart, Roy
AU - Grupper, Avishay
AU - Sternik, Leonid
AU - Lavee, Jacob
AU - Sacher, Frric
AU - Kautzner, Josef
AU - Sabbag, Avi
N1 - Publisher Copyright:
© 2021 Published on behalf of the European Society of Cardiology. All rights reserved.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Aim: To describe clinical characteristics, procedural details, specific challenges, and outcomes in patients with HeartMate3™ (HM3), a left ventricular assist device system with a magnetically levitated pump, undergoing ventricular tachycardia ablation (VTA). Methods and results: Data were collected from patients with an HM3 system who underwent VTA in seven tertiary centres. Data included baseline patient characteristics, procedural data, mortality, and arrhythmia-free survival. The study cohort included 19 patients with cardiomyopathy presenting with ventricular tachycardia (VT) (53% with VT storm). Ventricular tachycardias were induced in 89% of patients and a total of 41 VTs were observed. Severe electromagnetic interference was present on the surface electrocardiogram. Hence, VT localization required analysis of intra-cardiac signals or the use of filter in the 40-20 Hz range. The large house pump HM3 design obscured the cannula inflow and therefore multi imaging modalities were necessary to avoid catheter entrapment in the cannula. A total of 32 VTs were mapped and were successfully ablated (31% to the anterior wall, 38% to the septum and only 9% to the inflow cannula region). Non-inducibility of any VT was reached in 11 patients (58%). Over a follow-up of 429 (interquartile range 101-692) days, 5 (26%) patients underwent a redo VT ablation due to recurrent VTA and 2 (11%) patients died. Conclusions: Ventricular tachycardia ablation in patients with HM3 is feasible and safe when done in the appropriate setup. Long-Term arrhythmia-free survival is acceptable but not well predicted by non-inducibility at the end of the procedure.
AB - Aim: To describe clinical characteristics, procedural details, specific challenges, and outcomes in patients with HeartMate3™ (HM3), a left ventricular assist device system with a magnetically levitated pump, undergoing ventricular tachycardia ablation (VTA). Methods and results: Data were collected from patients with an HM3 system who underwent VTA in seven tertiary centres. Data included baseline patient characteristics, procedural data, mortality, and arrhythmia-free survival. The study cohort included 19 patients with cardiomyopathy presenting with ventricular tachycardia (VT) (53% with VT storm). Ventricular tachycardias were induced in 89% of patients and a total of 41 VTs were observed. Severe electromagnetic interference was present on the surface electrocardiogram. Hence, VT localization required analysis of intra-cardiac signals or the use of filter in the 40-20 Hz range. The large house pump HM3 design obscured the cannula inflow and therefore multi imaging modalities were necessary to avoid catheter entrapment in the cannula. A total of 32 VTs were mapped and were successfully ablated (31% to the anterior wall, 38% to the septum and only 9% to the inflow cannula region). Non-inducibility of any VT was reached in 11 patients (58%). Over a follow-up of 429 (interquartile range 101-692) days, 5 (26%) patients underwent a redo VT ablation due to recurrent VTA and 2 (11%) patients died. Conclusions: Ventricular tachycardia ablation in patients with HM3 is feasible and safe when done in the appropriate setup. Long-Term arrhythmia-free survival is acceptable but not well predicted by non-inducibility at the end of the procedure.
KW - Ablation
KW - Left ventricular assist device
KW - Ventricular tachycardia
UR - http://www.scopus.com/inward/record.url?scp=85128245437&partnerID=8YFLogxK
U2 - 10.1093/europace/euab272
DO - 10.1093/europace/euab272
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C2 - 34791165
AN - SCOPUS:85128245437
SN - 1099-5129
VL - 24
SP - 598
EP - 605
JO - Europace
JF - Europace
IS - 4
ER -