PMID- 36329994
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221105
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 9
DP  - 2022
TI  - Early de-cannulation from extracorporeal membrane oxygenation following 
      ventricular tachycardia radiofrequency ablation.
PG  - 998079
LID - 10.3389/fcvm.2022.998079 [doi]
LID - 998079
AB  - OBJECTIVES: Ventricular tachycardia ablation (VTA) with hemodynamic compromise 
      presents a challenge. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) 
      support allows the safe completion of the procedure. There are limited data 
      regarding the safety of weaning off VA-ECMO at the end of the procedure. We 
      report our experience with early VA-ECMO de-cannulation after VTA. MATERIALS AND 
      METHODS: All patients undergoing VA-ECMO-assisted VTA, between January 2013 and 
      December 2020 at a large tertiary center were included. Clinical characteristics, 
      history of arrhythmia, procedural details, and outcomes were collected. Patients 
      weaned from VA-ECMO immediately at the end of the procedure were compared to 
      those that were de-cannulated at a later time. RESULTS: A total of 46 patients 
      (93.5% male, age 62 +/- 10 years) were ablated with VA-ECMO support. Most had 
      ischemic cardiomyopathy (65%) and (70%) presented with VT storm. The clinical VT 
      was induced in the majority of patients (76%). A total of 99 VTs were induced of 
      which 76 (77%) were targeted and successfully ablated. Non-inducibility was 
      achieved in 74% of cases and most patients (83%) were de-cannulated at the end of 
      the procedure on the procedure table. Survival at 1 year was higher among early 
      de-cannulated patients (86 vs. 38% [log-rank p-value < 0.001]). At 1-year 
      follow-up, 91.3% of surviving patients were free of appropriate ICD shocks. 
      CONCLUSION: De-cannulation from VA-ECMO may be done immediately at the conclusion 
      of VTA in most cases. Failure to timely wean off VA-ECMO is a strong predictor of 
      mortality.
CI  - Copyright (c) 2022 Sabbag, Nissan, Beinart, Sternik, Kassif, Kogan, Ram and Nof.
FAU - Sabbag, Avi
AU  - Sabbag A
AD  - Davidai Arrhythmia Center, Sheba Medical Center, Ramat Gan, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
FAU - Nissan, Johnatan
AU  - Nissan J
AD  - Davidai Arrhythmia Center, Sheba Medical Center, Ramat Gan, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
FAU - Beinart, Roy
AU  - Beinart R
AD  - Davidai Arrhythmia Center, Sheba Medical Center, Ramat Gan, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
FAU - Sternik, Leonid
AU  - Sternik L
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
AD  - Department of Cardiac Surgery, Sheba Medical Center, Ramat Gan, Israel.
FAU - Kassif, Igal
AU  - Kassif I
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
AD  - Department of Cardiac Surgery, Sheba Medical Center, Ramat Gan, Israel.
FAU - Kogan, Alexander
AU  - Kogan A
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
AD  - Department of Cardiac Surgery, Sheba Medical Center, Ramat Gan, Israel.
FAU - Ram, Eilon
AU  - Ram E
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
AD  - Department of Cardiac Surgery, Sheba Medical Center, Ramat Gan, Israel.
FAU - Nof, Eyal
AU  - Nof E
AD  - Davidai Arrhythmia Center, Sheba Medical Center, Ramat Gan, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
LA  - eng
PT  - Journal Article
DEP - 20221018
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC9622793
OTO - NOTNLM
OT  - ablation
OT  - circulatory support
OT  - early de-cannulation
OT  - extracorporeal membrane oxygenation
OT  - vetricular tachycardia
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/11/05 06:00
MHDA- 2022/11/05 06:01
PMCR- 2022/01/01
CRDT- 2022/11/04 02:23
PHST- 2022/07/19 00:00 [received]
PHST- 2022/09/23 00:00 [accepted]
PHST- 2022/11/04 02:23 [entrez]
PHST- 2022/11/05 06:00 [pubmed]
PHST- 2022/11/05 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2022.998079 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2022 Oct 18;9:998079. doi: 10.3389/fcvm.2022.998079. 
      eCollection 2022.