Ablation of Ventricular Tachycardia With Percutaneous Hemodynamic Support

In many cases, hemodynamic instability limits the ability to perform activation mapping during scar-related ventricular tachycardia (VT). Catecholamines may support blood pressure, but overall perfusion may be suboptimal, and these agents can produce cardiotoxicity. Mechanical hemodynamic support can facilitate mapping by maintaining perfusion to vital organs for extended periods of time during ongoing VT. Types of hemodynamic support include intraaortic balloon counterpulsation and percutaneous left ventricular assist devices of several types. In this chapter, different methods of hemodynamic support for facilitating activation mapping during VT will be discussed, including advantages and disadvantages to their use.