PMID- 33153905
OWN - NLM
STAT- MEDLINE
DCOM- 20210929
LR  - 20210929
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 30
IP  - 4
DP  - 2021 Apr
TI  - Ventricular Tachycardia Storm Ablation With Pre-Emptive Circulatory Support by 
      Extracorporeal Membrane Oxygenation: Australian Experience.
PG  - 555-566
LID - S1443-9506(20)31412-8 [pii]
LID - 10.1016/j.hlc.2020.09.926 [doi]
AB  - BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can 
      provide circulatory support in high-risk patients undergoing drug refractory 
      ventricular tachycardia (VT) ablation procedures. We report experience using 
      VA-ECMO in a pre-emptive approach for high-risk patients with VT storm and 
      previously ineffective ablation procedures. METHODS AND RESULTS: Four (4) 
      patients with drug refractory ventricular tachycardia (mean age 61+/-3 years; left 
      ventricular ejection fraction 21+/-5%) presenting for VT ablation had pre-emptive 
      VA-ECMO. All patients during current admission had VT storm. Pre-ablation, 22 
      total monomorphic VTs (cycle length 402+/-69 ms) were induced or spontaneously 
      observed (median of 4, IQR(25-75%) 1-6). At the end of the procedure, 86% of all 
      inducible VTs were rendered non-inducible. Median hospitalisation following 
      VA-ECMO supported ablation was 5 days (IQR(25-75%) 3-12). During follow-up 
      (median 138 days [IQR(25-75%) 57-277]), VT recurred in one patient as an isolated 
      episode reverted by anti-tachycardia pacing. There was a 99% reduction in VT 
      burden post ablation. One (1) patient died of cardiogenic shock within 24 hours 
      whilst still on VA-ECMO, all other patients were successfully weaned off support 
      and discharged. Two (2) patients underwent cardiac transplantation at 199 and 512 
      days post ablation following implantation of ventricular assist devices for 
      worsening heart failure. CONCLUSIONS: The pre-emptive use of VA-ECMO for 
      high-risk patients undergoing catheter ablation for VT storm was found to be 
      effective in maintaining haemodynamic status, and allowing successful mapping and 
      catheter ablation for VT.
CI  - Crown Copyright (c) 2020. Published by Elsevier B.V. All rights reserved.
FAU - Campbell, Timothy
AU  - Campbell T
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead 
      Applied Research Centre, University of Sydney, NSW, Australia.
FAU - Bennett, Richard G
AU  - Bennett RG
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead 
      Applied Research Centre, University of Sydney, NSW, Australia.
FAU - Lee, Vickie
AU  - Lee V
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.
FAU - Turnbull, Samual
AU  - Turnbull S
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead 
      Applied Research Centre, University of Sydney, NSW, Australia.
FAU - Eslick, Adam
AU  - Eslick A
AD  - Department of Anaesthesia, Westmead Hospital, Sydney, NSW, Australia.
FAU - Kruit, Natalie
AU  - Kruit N
AD  - Department of Anaesthesia, Westmead Hospital, Sydney, NSW, Australia.
FAU - Pudipeddi, Anand
AU  - Pudipeddi A
AD  - Department of Anaesthesia, Westmead Hospital, Sydney, NSW, Australia.
FAU - Hing, Alfred
AU  - Hing A
AD  - Department of Cardiothoracic Surgery, Westmead Hospital, Sydney, NSW, Australia.
FAU - Kizana, Eddy
AU  - Kizana E
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.
FAU - Thomas, Stuart P
AU  - Thomas SP
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead 
      Applied Research Centre, University of Sydney, NSW, Australia.
FAU - Kumar, Saurabh
AU  - Kumar S
AD  - Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead 
      Applied Research Centre, University of Sydney, NSW, Australia. Electronic 
      address: saurabh.kumar@sydney.edu.au.
LA  - eng
PT  - Journal Article
DEP - 20201103
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
SB  - IM
MH  - Australia/epidemiology
MH  - *Catheter Ablation
MH  - *Extracorporeal Membrane Oxygenation
MH  - Humans
MH  - Middle Aged
MH  - Stroke Volume
MH  - *Tachycardia, Ventricular/surgery
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Catheter ablation
OT  - Extracorporeal membrane oxygenation
OT  - Ventricular tachycardia
EDAT- 2020/11/07 06:00
MHDA- 2021/09/30 06:00
CRDT- 2020/11/06 05:43
PHST- 2020/05/20 00:00 [received]
PHST- 2020/08/17 00:00 [revised]
PHST- 2020/09/07 00:00 [accepted]
PHST- 2020/11/07 06:00 [pubmed]
PHST- 2021/09/30 06:00 [medline]
PHST- 2020/11/06 05:43 [entrez]
AID - S1443-9506(20)31412-8 [pii]
AID - 10.1016/j.hlc.2020.09.926 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2021 Apr;30(4):555-566. doi: 10.1016/j.hlc.2020.09.926. Epub 
      2020 Nov 3.