Cardiopulmonary support during electrophysiological procedures for ventricular tachycardias not haemodynamically tolerated

Abstract

The objectives of this study were to evaluate the efficacy of percutaneous cardiopulmonary support (CPS) for circulatory assistance during electrophysiological endocavitary procedures for ventricular tachycardia (VT) in high-risk patients. From January to June 1999, eight patients with VT not haemodynamically tolerated, underwent an electrophysiological mapping and ablation while supported with percutaneous CPS in the cardiac surgery service of the University of Milan. The CPS system allowed for the maintenance of an arterial pressure of 60-70 mmHg during the tachycardia episodes. CPS was used for 10-20 min periods to restore haemodynamic stability. With the haemodynamic support of CPS, it was possible to target and induce 21 VTs, with a mean cycle of 325 ms. The mean support time was 140 min (120-160 min). Stabilization of the arterial pressure at a mean value of 65 mmHg (55-85 mHg) was achieved over a mean period of 26 seconds. Oxygen saturation remained over 90% throughout the support for all patients, with no blood gas or electrolyte abnormalities. No CPB-related complications were observed. In conclusion, percutaneous CPS guarantees effective haemodynamic support during mapping and ablation of VTs not haemodynamically tolerated, with no complications related to the extracorporeal circulation or the cannulation.

Percutaneous extracorporeal membrane oxygenation in electrical storm: five case reports addressing efficacy, transferring allowance or radiofrequency ablation support

“…It enables us to define accurately the VT circuit, identify the critical isthmus, and perform limited ablation to terminate VT. A placement of an ECMO to ensure haemodynamic stability during VT thereby permits detailed activation and entrainment mapping during the clinical tachycardia and enables ablation to be performed with better outcomes. [25][26][27] Finally, VA-ECMO allows a haemodynamically stable and safe inter-hospital transfer.…”

Ventricular Tachycardia Ablation

“…[118][119][120][121][122] Various types of mechanical support have been used and are associated with unique advantages and limitations in the VT setting. [118][119][120][121][122] Various types of mechanical support have been used and are associated with unique advantages and limitations in the VT setting.…”

Novel Multi-Functional Life Support System

“…CPS, ECMO, and VS are all common therapies indicated for various pathologies and circumstances (1)(2)(3)(4)(5)(6). While there are many devices to perform these support modalities there are significant costs associated with purchasing and maintaining the related hardware.…”