ArticleJournal of cardiothoracic surgery2025
Hybrid catheter ablation and minimally invasive LVAD implantation in a high-risk patient with refractory ventricular tachycardia.
Article in Journal of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe suitability of left ventricular assist device (LVAD) implantation in patients with end-stage heart failure who present with preoperative frequent ventricular arrhythmias(VAs) remains controversial. Developing effective strategies to reduce the occurrence of postoperative VAs is a key clinical priority. CASE PRESENTATION: A 59-year-old woman with hypertrophic cardiomyopathy and end-stage heart failure presented with recurrent Ventricular Tachycardia (VT) refractory to pharmacotherapy and electrical cardioversion. Transplantation difficulties included hemodynamic instability, panel-reactive antibody sensitization and limited donor resource. We performed a single-stage minimally invasive approach to treat the patient, including VT radiofrequency ablation, atrial septal defect (ASD) closure, and minimally invasive left lateral LVAD implantation. Transient VT recurrence on postoperative day 4 resolved with amiodarone. The patient achieved stable hemodynamics, was extubated by day 2, and discharged on day 21. At 15-month follow-up, she maintained improved quality of life without sustained VT episodes and stable cardiac function.
conclusionsThis hybrid minimally invasive strategy demonstrates the feasibility as a destination or bridge therapy for high-risk patients with refractory arrhythmias and transplant difficulties. Long-term outcomes require further evaluation.
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