Early experience with mechanical hemodynamic support for catheter ablation of malignant ventricular tachycardia
10.3760/cma.j.cn112148-20240410-00194
- VernacularTitle:血流动力学不稳定的室性心动过速循环辅助支持下的导管消融治疗
- Author:
Mengmeng LI
1
;
Yang YANG
;
Deyong LONG
;
Chenxi JIANG
;
Ribo TANG
;
Caihua SANG
;
Wei WANG
;
Xin ZHAO
;
Xueyuan GUO
;
Songnan LI
;
Changyi LI
;
Man NING
;
Changqi JIA
;
Li FENG
;
Dan WEN
;
Hui ZHU
;
Yuexin JIANG
;
Fang LIU
;
Tong LIU
;
Jianzeng DONG
;
Changsheng MA
Author Information
1. 首都医科大学附属北京安贞医院心律失常中心 国家心血管疾病临床医学研究中心，北京 100029
- Keywords:
Catheter ablation;
Ventricular tachycardia;
Mechanical circulatory support;
Hemodynamical instability;
Extracorporeal membrane oxygenation;
Left ventricula
- From:
Chinese Journal of Cardiology
2024;52(7):768-776
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the role of mechanical hemodynamic support (MHS) in mapping and catheter ablation of patients with hemodynamically unstable ventricular tachycardia (VT), report single-center experience in a cohort of consecutive patients receiving VT ablation during MHS therapy, and provide evidence-based medical evidence for clinical practice.Methods:This was a retrospective cohort study. Patients with hemodynamically unstable VT who underwent catheter ablation with MHS at Beijing Anzhen Hospital, Capital Medical University between August 2021 and December 2023 were included. Patients were divided into rescue group and preventive group according to the purpose of treatment. Their demographic data, periprocedural details, and clinical outcomes were collected and analyzed.Results:A total of 15 patients with hemodynamically unstable VT were included (8 patients in the rescue group and 7 patients in the preventive group). The acute procedure was successful in all patients. One patient in the rescue group had surgical left ventricular assist device (LVAD) implantation, remaining 14 patients received extracorporeal membrane oxygenation (ECMO) for circulation support. ECMO decannulation was performed in 12 patients due to clinical and hemodynamic stability, of which 6 patients were decannulation immediately after surgery and the remaining patients were decannulation at 2.0 (2.5) d after surgery. Two patients in the rescue group died during the index admission due to refractory heart failure and cerebral hemorrhage. During a median follow-up of 30 d (1 d to 12 months), one patient with LVAD had one episode of ventricular fibrillation at 6 months after discharge, and no further episodes of ventricular fibrillation and/or VT occurred after treatment with antiarrhythmic drugs. No malignant ventricular arrhythmia occurred in the remaining 12 patients who were followed up.Conclusions:MHS contributes to the successful completion of mapping and catheter ablation in patients with hemodynamically unstable VT, providing desirable hemodynamic status for emergency and elective conditions.
