PMID- 31977352
OWN - NLM
STAT- MEDLINE
DCOM- 20210301
LR  - 20210301
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 66
IP  - 9
DP  - 2020 Sep/Oct
TI  - Venoarterial Extracorporeal Membrane Oxygenation Support for Ventricular 
      Tachycardia Ablation: A Systematic Review.
PG  - 980-985
LID - 10.1097/MAT.0000000000001125 [doi]
AB  - Refractory ventricular tachycardia (VT) and electrical storm are frequently 
      associated with hemodynamic compromise requiring mechanical support. This study 
      sought to review the current literature on the use of venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO) for hemodynamic support during VT ablation. This 
      was a systematic review of all published literature from 2000 to 2019 evaluating 
      patients with VT undergoing ablation with VA-ECMO support. Studies that reported 
      mortality, safety, and efficacy outcomes in adult (>18 years) patients were 
      included. The primary outcome was short-term mortality (intensive care unit stay, 
      hospital stay, or </=30 days). The literature search identified 4,802 citations 
      during the study period, of which seven studies comprising 867 patients met the 
      inclusion criteria. Periprocedural VA-ECMO was used in 129 (15%) patients and all 
      were placed peripherally. Average inducible VTs were 2-3 per procedure and 
      ablation time varied between 34 mins and 4.7 hours. Median ages were between 61 
      and 68 years with 93% males. Median duration of VA-ECMO varied between 140 
      minutes and 6 days. Short-term mortality was 15% (19 patients), with the most 
      frequent causes being refractory VT, cardiac arrest, and acute heart failure. 
      All-cause mortality at the longest follow-up was 25%. Major bleeding, 
      vascular/access complications, limb ischemia, stroke, and acute kidney injury 
      were reported with varying frequency of 1-6%. In conclusion, VA-ECMO is used 
      infrequently for hemodynamic support for VT ablation. Further data on patient 
      selection, procedural optimization, and clinical outcomes are needed to evaluate 
      the efficacy of this strategy.
FAU - Vallabhajosyula, Saraschandra
AU  - Vallabhajosyula S
AD  - From the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Vallabhajosyula, Saarwaani
AU  - Vallabhajosyula S
FAU - Vaidya, Vaibhav R
AU  - Vaidya VR
FAU - Patlolla, Sri Harsha
AU  - Patlolla SH
FAU - Desai, Viral
AU  - Desai V
FAU - Mulpuru, Siva K
AU  - Mulpuru SK
FAU - Noseworthy, Peter A
AU  - Noseworthy PA
FAU - Kapa, Suraj
AU  - Kapa S
FAU - Egbe, Alexander C
AU  - Egbe AC
FAU - Gersh, Bernard J
AU  - Gersh BJ
FAU - Deshmukh, Abhishek J
AU  - Deshmukh AJ
LA  - eng
GR  - UL1 TR000135/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Systematic Review
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Adult
MH  - Aged
MH  - Catheter Ablation/*methods
MH  - Extracorporeal Membrane Oxygenation/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Tachycardia, Ventricular/surgery/*therapy
EDAT- 2020/01/25 06:00
MHDA- 2021/03/02 06:00
CRDT- 2020/01/25 06:00
PHST- 2020/01/25 06:00 [pubmed]
PHST- 2021/03/02 06:00 [medline]
PHST- 2020/01/25 06:00 [entrez]
AID - 00002480-202009000-00002 [pii]
AID - 10.1097/MAT.0000000000001125 [doi]
PST - ppublish
SO  - ASAIO J. 2020 Sep/Oct;66(9):980-985. doi: 10.1097/MAT.0000000000001125.