Percutaneous left ventricular assist device support during ablation of ventricular tachycardia: A meta-analysis of current evidence

Faraz Khan Luni, Nath Zungsontiporn, Talha Farid, Sonia Ali Malik, Sobia Khan, James Daniels, Richard Wu, Mark S. Link, Jose A. Joglar

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Catheter ablation of ventricular tachycardia (VT) can be an effective therapy to reduce VT burden, but often it is limited by the potential for hemodynamic instability. Percutaneous left ventricular assist devices (pLVADs) have been used to maintain hemodynamic support during VT ablation but the evidence regarding its clinical impact has been inconclusive. Methods and Results: We sought to assess the clinical impact of pLVAD when used in VT ablation by conducting a meta-analysis of the current evidence. We searched Pubmed and found nine observational studies that compared clinical outcomes of VT ablation in patients with pLVAD support to controls with no pLVAD support. The pooled data did not show a significant difference in mortality between both groups, nor a difference in acute procedural success or in recurrence of VT. There was also no difference in the number of patients receiving a cardiac transplant or being enrolled in the transplant list. Although there was no difference in the ablation time between the groups, patients in the pLVAD group had a longer total procedural time and more procedure-related adverse effects. Conclusion: This meta-analysis did not show clinical benefits from using pLVAD support during VT ablation, whereas it was associated with longer procedure times and more complications. This study was, however, limited by the observational nature of the data. In view of these data, the risk and benefit of pLVAD support during VT ablation should be considered on an individual basis.

Original languageEnglish (US)
Pages (from-to)886-895
Number of pages10
JournalJournal of Cardiovascular Electrophysiology
Volume30
Issue number6
DOIs
StatePublished - Jun 1 2019

Fingerprint

Heart-Assist Devices
Ventricular Tachycardia
Meta-Analysis
Hemodynamics
Transplants
Catheter Ablation
PubMed
Observational Studies
Recurrence
Mortality

Keywords

  • ablation
  • meta-analysis
  • percutaneous left ventricular assist device (pLVAD)
  • ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{0081fbd1ee134a1cbcafe1aeef447a2c,
title = "Percutaneous left ventricular assist device support during ablation of ventricular tachycardia: A meta-analysis of current evidence",
abstract = "Introduction: Catheter ablation of ventricular tachycardia (VT) can be an effective therapy to reduce VT burden, but often it is limited by the potential for hemodynamic instability. Percutaneous left ventricular assist devices (pLVADs) have been used to maintain hemodynamic support during VT ablation but the evidence regarding its clinical impact has been inconclusive. Methods and Results: We sought to assess the clinical impact of pLVAD when used in VT ablation by conducting a meta-analysis of the current evidence. We searched Pubmed and found nine observational studies that compared clinical outcomes of VT ablation in patients with pLVAD support to controls with no pLVAD support. The pooled data did not show a significant difference in mortality between both groups, nor a difference in acute procedural success or in recurrence of VT. There was also no difference in the number of patients receiving a cardiac transplant or being enrolled in the transplant list. Although there was no difference in the ablation time between the groups, patients in the pLVAD group had a longer total procedural time and more procedure-related adverse effects. Conclusion: This meta-analysis did not show clinical benefits from using pLVAD support during VT ablation, whereas it was associated with longer procedure times and more complications. This study was, however, limited by the observational nature of the data. In view of these data, the risk and benefit of pLVAD support during VT ablation should be considered on an individual basis.",
keywords = "ablation, meta-analysis, percutaneous left ventricular assist device (pLVAD), ventricular tachycardia",
author = "Luni, {Faraz Khan} and Nath Zungsontiporn and Talha Farid and Malik, {Sonia Ali} and Sobia Khan and James Daniels and Richard Wu and Link, {Mark S.} and Joglar, {Jose A.}",
year = "2019",
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TY - JOUR

T1 - Percutaneous left ventricular assist device support during ablation of ventricular tachycardia

T2 - A meta-analysis of current evidence

AU - Luni, Faraz Khan

AU - Zungsontiporn, Nath

AU - Farid, Talha

AU - Malik, Sonia Ali

AU - Khan, Sobia

AU - Daniels, James

AU - Wu, Richard

AU - Link, Mark S.

AU - Joglar, Jose A.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Introduction: Catheter ablation of ventricular tachycardia (VT) can be an effective therapy to reduce VT burden, but often it is limited by the potential for hemodynamic instability. Percutaneous left ventricular assist devices (pLVADs) have been used to maintain hemodynamic support during VT ablation but the evidence regarding its clinical impact has been inconclusive. Methods and Results: We sought to assess the clinical impact of pLVAD when used in VT ablation by conducting a meta-analysis of the current evidence. We searched Pubmed and found nine observational studies that compared clinical outcomes of VT ablation in patients with pLVAD support to controls with no pLVAD support. The pooled data did not show a significant difference in mortality between both groups, nor a difference in acute procedural success or in recurrence of VT. There was also no difference in the number of patients receiving a cardiac transplant or being enrolled in the transplant list. Although there was no difference in the ablation time between the groups, patients in the pLVAD group had a longer total procedural time and more procedure-related adverse effects. Conclusion: This meta-analysis did not show clinical benefits from using pLVAD support during VT ablation, whereas it was associated with longer procedure times and more complications. This study was, however, limited by the observational nature of the data. In view of these data, the risk and benefit of pLVAD support during VT ablation should be considered on an individual basis.

AB - Introduction: Catheter ablation of ventricular tachycardia (VT) can be an effective therapy to reduce VT burden, but often it is limited by the potential for hemodynamic instability. Percutaneous left ventricular assist devices (pLVADs) have been used to maintain hemodynamic support during VT ablation but the evidence regarding its clinical impact has been inconclusive. Methods and Results: We sought to assess the clinical impact of pLVAD when used in VT ablation by conducting a meta-analysis of the current evidence. We searched Pubmed and found nine observational studies that compared clinical outcomes of VT ablation in patients with pLVAD support to controls with no pLVAD support. The pooled data did not show a significant difference in mortality between both groups, nor a difference in acute procedural success or in recurrence of VT. There was also no difference in the number of patients receiving a cardiac transplant or being enrolled in the transplant list. Although there was no difference in the ablation time between the groups, patients in the pLVAD group had a longer total procedural time and more procedure-related adverse effects. Conclusion: This meta-analysis did not show clinical benefits from using pLVAD support during VT ablation, whereas it was associated with longer procedure times and more complications. This study was, however, limited by the observational nature of the data. In view of these data, the risk and benefit of pLVAD support during VT ablation should be considered on an individual basis.

KW - ablation

KW - meta-analysis

KW - percutaneous left ventricular assist device (pLVAD)

KW - ventricular tachycardia

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