AI Article Synopsis
- Ventricular arrhythmias frequently occur after the implantation of a left ventricular assist device (LVAD), often due to existing heart conditions like cardiomyopathy.
- A case study highlights a 59-year-old woman with severe heart failure and recurrent ventricular tachycardia (VT) who underwent successful LVAD implantation with concomitant epicardial mapping and ablation of arrhythmogenic areas.
- Post-surgery, the patient experienced no VT episodes during a 15-month follow-up without needing anti-arrhythmic medication, suggesting the effectiveness of intraoperative ablation in managing recurrent ventricular arrhythmias in LVAD patients.
Article Abstract
Background: Ventricular arrhythmias (VAs) are common after a left ventricular assist device (LVAD) implantation. Further, the majority of post-LVAD ventricular tachycardias (VTs) are secondary to a preexisting cardiomyopathy substrate. Intraoperative ablation of patients with recurrent preoperative VTs may reduce post-LVAD VTs.
Case Summary: A 59-year-old female with advanced heart failure due to non-ischaemic cardiomyopathy (LV ejection fraction = 24%) and recurrent VTs was referred for an LVAD implantation as a bridge to a heart transplant (INTERMACS Profile-5A). The previous endocardial ablation failed due to an epicardial arrhythmogenic substrate. Therefore, open-chest epicardial mapping during the LVAD implantation was indicated and three target areas of the arrhythmogenic substrate were found, which were ablated by radiofrequency applications. To minimize the cardiopulmonary bypass time, cardiopulmonary bypass was initiated after ablation, and then, an LVAD was implanted. An additional 68 min was required for mapping and ablation. All procedures were performed without any complications, and the post-operative course was uneventful. Thereafter, no VT episodes were observed without any anti-arrhythmic drugs during a 15-month follow-up with LVAD support.
Discussion: Intraoperative epicardial mapping and ablation during an LVAD implantation can play an important role in the management of LVAD recipients with recurrent VAs.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10325002 | PMC |
| http://dx.doi.org/10.1093/ehjcr/ytad277 | DOI Listing |
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