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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Open Ablation of the Left Ventricle During Implantation of a Left Ventricular Assist Device
Yuriy Hrytsyna1, Jin-Hong Gerds-Li2, Roland Heck1
1Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.
Insights
This study details successful treatment of persistent ventricular tachycardia during left ventricular assist device (LVAD) implantation. Radiofrequency ablation combined with LVAD implantation effectively stabilized the patient's cardiac rhythm.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Persistent ventricular tachycardia (VT) poses a significant challenge in patients with ischemic cardiomyopathy.
- Recurrent VT can lead to cardiac decompensation, necessitating advanced interventions.
- Left ventricular assist device (LVAD) implantation is a critical option for end-stage heart failure.
Observation:
- A 66-year-old patient with ischemic cardiomyopathy presented with recurrent VT causing cardiac decompensation.
- The patient underwent implantation of a HeartMate 3 LVAD.
- During the procedure, radiofrequency ablation was performed using an AtriCure Isolator Synergy OLL2 clamp.
Findings:
- Four sets of transmural radiofrequency lesions were created in the left ventricle.
- Transmurality of all lesions was confirmed.
- The ablation lesions were connected with an epicardial ablation line.
Implications:
- This combined approach of radiofrequency ablation and LVAD implantation offers a potential solution for managing refractory VT in patients with severe cardiomyopathy.
- Successful rhythm stabilization post-procedure suggests the efficacy of this integrated therapeutic strategy.
- The patient's uneventful discharge with a stable rhythm highlights the safety and effectiveness of this intervention.
Abstract:
This report describes the successful treatment of persistent ventricular tachycardia in a 66-year-old patient with ischemic cardiomyopathy during left ventricular assist device (LVAD) implantation. Recurrent episodes of ventricular tachycardia led to cardiac decompensation necessitating LVAD implantation. After opening the left ventricle, an AtriCure Isolator Synergy OLL2 radiofrequency clamp was used to perform 4 sets of transmural lesions. Transmurality was observed in all lesions. A HeartMate 3 (Abbott) LVAD was implanted in standard fashion. The lesions were connected with an epicardial ablation line using a radiofrequency catheter. The patient was discharged home without complications and with a stable rhythm.
