Combined Pulsed Field and Radiofrequency Energy for Ablation of Ventricular Tachycardia

Who can take part

• Patients with two or more documented spontaneous episodes of sustained symptomatic VT within 3 months or 1 sustained episode of VT or VT storm (two or more VTs in 24 hours) which required device therapy (shock or anti-tachycardia pacing), external cardioversion, escalated antiarrhythmic therapy, and / or hospitalization; Documented episodes assessment will be performed by a review of ECGs, hospitalization records, and/or Implantable Cardioverter Defibrillator (ICD) interrogation; Patients must have an ICD implanted
• Age ≥18 years
• LVEF ≥ 30% as estimated by echocardiography, contrast ventriculography, radionuclide imaging or cardiac magnetic resonance imaging within the previous 30 days
• Willing and capable of understanding the objective, risk, and requirement of the study, and providing consent
• Able and willing to comply with all pre-, post- and follow-up testing and requirements

Who cannot take part

• Enrolled in an investigational study evaluating another device or drug
• Previous VT ablation within a year
• Myocardial infarction (MI) within the preceding 2 months. Patients with incessant VT (present 50% of the time with intervention for a period >12 hrs) may be enrolled if their MI is at least 3 weeks old
• Absence of vascular access to the heart chambers
• Other disease process likely to limit survival to less than 6 months
• Class IV heart failure
• Cardiac surgery (i.e. ventriculotomy, atriotomy) within the past 2 months. Patients with incessant VT may be enrolled if their surgery is at least 3 weeks old
• Acute illness or active systemic infection
• Uncontrolled heart failure
• Serum creatinine of ≥ 2.5 mg/dl (221 umol/L)
• Thrombocytopenia (< 50 x 109/L) or coagulopathy
• Definite protruding LV thrombus on pre-ablation imaging
• Contraindication to heparin
• Women who are pregnant
• Severe aortic stenosis or flail mitral valve
• Significant congenital anomaly or medical problem that in the opinion of the principal Investigator would preclude enrollment in the study
• Unwilling to participate in the study or unavailable for follow up visits
• Epicardial mapping or ablation is anticipated or planned before the VT ablation procedure