Objective. To report the results of ventricular tachycardia (VT) catheter ablation in ischemic heart disease (IHD), and to identify risk factors associated with recurrence in a Mexican center. Materials and methods. We made a retrospective review of the cases of VT ablation performed in our center from 2015 to 2022. We analyzed the characteristics of the patients and those of the procedures separately and we determined factors associated with recurrence. Results. Fifty procedures were performed in 38 patients (84% male; mean age 58.1 years). Acute success rate was 82%, with a 28% of recurrences. Female sex (OR 3.33, IC 95% 1.66–6.68, p=0.006), atrial fibrillation (OR 3.5, IC 95% 2.08–5.9, p=0.012), electrical storm (OR 2.4, IC 95% 1.06–5.41, p=0.045), functional class greater than II (OR 2.86, IC 95% 1.34–6.10, p=0.018) were risk factors for recurrence and the presence of clinical VT at the time of ablation (OR0.29, IC95% 0.12–0.70, p=0.004) and the use of more than 2 techniques for mapping (OR 0.64, IC 95% 0.48–0.86, p=0.013) were protective factors. Conclusions. Ablation of ventricular tachycardia in ischemic heart disease has had good results in our center. The recurrence is similar to that reported by other authors and there are some factors associated with it.

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Catheter ablation is useful for reducing drug-refractory ventricular tachycardia (VT) episodes and can be lifesaving when VT is an incessant or arrhythmic storm. Left ventricular hemodynamic support may be required in patients with VT and hemodynamic instability. Extracorporeal membrane oxygenation (ECMO) support is an alternative to achieve ventricular tachycardia mapping and ablation over long periods of time. We present a case of successful catheter ablation of the substrate in a patient with ischemic heart disease and ventricular tachycardia with hemodynamic instability performed using venous-arterial ECMO support. There were no episodes of ventricular tachycardia after 2 years of follow-up.

Funding Acknowledgements Type of funding sources: None. Background - Introduction: Ablation in patients with Ebstein Anomaly (EA) and Wolff Parkinson White syndrome (WPW) is challenging due to the complex anatomy and the presence of multiple accessory pathways (AP). Objectives Report the results of our recent experience of ablation in patients with EA and WPW syndrome. Methods We conducted a retrospective review of the cases of EA and WPW syndrome, which were taken to ablation in our center between 2015 and 2020. Results We found that in the indicated period 30 electrophysiological studies and ablations had been performed in 26 patients, 53.8% were males and the mean age at the time of the study was 20.6 ± 9.1 years, the mean tricuspid septal valve attachment was 44.5 ± 17.7%. Regarding the procedures, 15 were conventional studies (50%) and 15 (50%) were performed with electroanatomical mapping. We used intracardiac echocardiogram (ICE) in 10 cases (33.3%). The acute success rate was 85.7% and in the follow-up 3 patients (10%) presented recurrence. Only one patient presented a major complication, which was a complete AV block. There was a tendency to improve the acute success with the use of electroanatomical mapping in comparation with conventional studies (93.3% vs 66.6%, p = 0.068), and with the use of ICE acute success was significantly improved (100% vs 70%, p = 0.04). Seven patients presented multiple accessory pathways (26.9%). The most frequent location was the right posterolateral with 61.53%, followed by the right posteroseptal with 26.9% and the right lateral with 19.2%. Conclusions The ablation in patients with EA and WPW syndrome constitutes a challenge, we found that the use of electroanatomical mapping and the use of ICE could improve the acute success rate. New studies are needed to demonstrate the usefulness of these techniques to improve the acute success rate and to reduce the recurrence rate. ProceduresProcedures (N = 30)N%Conventional procedures1550.0Electroanatomical mapping1550.0Intracardiac echocardiogram1033.3Acute success2485.7Recurrence310.0Major complication13.3Descriptive table of our experience in ablation of patients with ED and WPW syndrome.Abstract Figure. Location of the accessory pathways

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