Arrhythmias & electrophysiology
Percutaneous Ventricular Tachycardia (VT) Ablation Via Right Atrium (RA)-to-LV Access in Patients With Double Mechanical Valves: A Multicenter Registry
Authors' conclusion
In this multicenter registry of patients with double mechanical valves, VT ablation with RA-to-LV access was feasible, safe, and effective.
Study context
- Population
- Patients with double mechanical valves (mechanical aortic and mitral valves) who underwent VT ablation with RA-to-LV accesspatients from 10 VT ablation centers
- Participants
- 18 patients
- Outcome
- Baseline characteristics
Main finding
As reported in the abstract
Men
15
Age
63.9 ± 10 years
Left ventricle (LV) ejection fraction
32% ± 10%
Observational data: associations, not effects.
Further findings
Periprocedural anticoagulation
Patients
- Procedure performed on uninterrupted anticoagulation
- 14
- Bridging with heparin
- 4
Inducible VTs at procedure onset
- Mean number of inducible VTs
- 2.5
LV access success
- Radiofrequency wire
- n = 16
- Standard transseptal needle
- n = 2
- LV access successful in all cases
- Intracardiac echocardiography-guided puncture, followed by balloon dilation
Complete noninducibility of VT · Postablation
- Complete noninducibility of VT
- 17 (94%) patients
VT recurrence · median follow-up of 10.4 months
- VT recurrence
- 3 (17%) patients
Safety
Intramural perimitral annular hematoma · after LV access
- Intramural perimitral annular hematoma, managed conservatively without sequelae
- One
- No other procedure-related complications, such as new AV block
LV-RA shunt by echocardiogram · within 24 to 72 hours
- LV-RA shunt present
- 10 (56%) patients
- Small residual shunt more than 3 months postablation, of those with shunt
- 1 of them
Original publication
Percutaneous VT Ablation Via RA-to-LV Access in Patients With Double Mechanical Valves: A Multicenter Registry. JACC Clin Electrophysiol. Published 15 January 2025. doi:10.
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