Ventricular tachycardia (VT) in the setting of structural heart disease is challenging to treat with percutaneous catheter ablation due to the presence of complex substrate, multiple morphologies, hemodynamic instability, and epicardial circuits. When substrate-based approaches fail, however, it may be impossible to map and ablate hemodynamically unstable arrhythmias. We describe a novel approach to endocardial and epicardial mapping and ablation of hypotensive VT using a percutaneous left ventricular assist device in the electrophysiology laboratory, permitting near-surgical access to cardiac structures.
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Article Synopsis
- Epicardial adipose tissue (EAT) is linked to atrial fibrillation (AF) and atrial fibrosis, but many AF patients show no signs of left atrial (LA) fibrosis. This study compared EAT levels in AF patients without LA fibrosis to matched controls without AF.
- AF patients without LA fibrosis had significantly higher total and regional volumes of EAT compared to controls, indicating that EAT may play a role in AF development even when LA fibrosis is absent.
- The study found no differences in EAT volumes between AF patients with and without LA fibrosis and no significant link between EAT volume and AF recurrence after catheter ablation.
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