{
    "abstract": "The PAINESD score predicts the risk of periprocedural acute hemodynamic decompensation (AHD) and postprocedural mortality in patients undergoing catheter ablation (CA) of scar-related ventricular tachycardia (VT). The role of prophylactic placement of percutaneous left ventricular assist devices (pLVADs) in high-risk patients is unknown.\nThe purpose of this study was to evaluate the outcomes of prophylactic use of pLVAD in high-risk patients undergoing CA of scar-related VT.\nWe included 75 patients undergoing CA of scar-related VT in whom a prophylactic pLVAD was implanted because of perceived high risk. The control population was a propensity-matched group of 75 patients who did not undergo prophylactic pLVAD placement. The PAINESD score was used for propensity matching.\nThe median PAINESD score was 13 (41% with score \u226515) in the prophylactic pLVAD group and 12 (40% with score \u226515) in the control group. Periprocedural AHD occurred in 5 patients (7%) in the prophylactic pLVAD group and in 17 patients (23%) in the control group (P < .01). The 12-month cumulative incidence of VT was 40% in the prophylactic pLVAD group vs 41% in the control group (P = .97), while the 12-month incidence of death/transplant was 33% vs 66%, respectively (P < .01). In multivariable analysis, left ventricular ejection fraction (HR 0.97, 95% CI 0.95-0.99, P = .03), chronic kidney disease (HR 2.24, 95% CI 1.35-3.72, P < .01), VT recurrence (HR 2.33, 95% CI 1.31-4.14, P < .01), and prophylactic pLVAD (HR 0.28, 95% CI 0.16-0.49, P\u00a0< .01) were all independently associated with death/transplant.\nProphylactic pLVAD placement in high-risk patients undergoing CA of scar-related VT is associated with a reduced risk of AHD and death/transplant during follow-up without affecting VT-free survival.",
    "authors": [
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Daniele",
            "initials": "D",
            "lastname": "Muser"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Jackson J",
            "initials": "JJ",
            "lastname": "Liang"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Simon A",
            "initials": "SA",
            "lastname": "Castro"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Tatsuya",
            "initials": "T",
            "lastname": "Hayashi"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Andres",
            "initials": "A",
            "lastname": "Enriquez"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Gregory S",
            "initials": "GS",
            "lastname": "Troutman"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Nelson W",
            "initials": "NW",
            "lastname": "McNaughton"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Gregory",
            "initials": "G",
            "lastname": "Supple"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Edo Y",
            "initials": "EY",
            "lastname": "Birati"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Robert",
            "initials": "R",
            "lastname": "Schaller"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Fermin C",
            "initials": "FC",
            "lastname": "Garcia"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "David S",
            "initials": "DS",
            "lastname": "Frankel"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Sanjay",
            "initials": "S",
            "lastname": "Dixit"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "David J",
            "initials": "DJ",
            "lastname": "Callans"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Erica S",
            "initials": "ES",
            "lastname": "Zado"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.",
            "firstname": "Francis E",
            "initials": "FE",
            "lastname": "Marchlinski"
        },
        {
            "affiliation": "Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: pasquale.santangeli@uphs.upenn.edu.",
            "firstname": "Pasquale",
            "initials": "P",
            "lastname": "Santangeli"
        }
    ],
    "conclusions": "Prophylactic pLVAD placement in high-risk patients undergoing CA of scar-related VT is associated with a reduced risk of AHD and death/transplant during follow-up without affecting VT-free survival.",
    "copyrights": "Copyright \u00a9 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.hrthm.2018.04.028",
    "journal": "Heart rhythm",
    "keywords": [
        "Acute hemodynamic decompensation",
        "Catheter ablation",
        "Heart failure",
        "Heart transplant",
        "Mortality",
        "Percutaneous left ventricular assist device",
        "Ventricular tachycardia"
    ],
    "methods": null,
    "publication_date": "2018-05-14",
    "pubmed_id": "29753944",
    "results": "The median PAINESD score was 13 (41% with score \u226515) in the prophylactic pLVAD group and 12 (40% with score \u226515) in the control group. Periprocedural AHD occurred in 5 patients (7%) in the prophylactic pLVAD group and in 17 patients (23%) in the control group (P < .01). The 12-month cumulative incidence of VT was 40% in the prophylactic pLVAD group vs 41% in the control group (P = .97), while the 12-month incidence of death/transplant was 33% vs 66%, respectively (P < .01). In multivariable analysis, left ventricular ejection fraction (HR 0.97, 95% CI 0.95-0.99, P = .03), chronic kidney disease (HR 2.24, 95% CI 1.35-3.72, P < .01), VT recurrence (HR 2.33, 95% CI 1.31-4.14, P < .01), and prophylactic pLVAD (HR 0.28, 95% CI 0.16-0.49, P\u00a0< .01) were all independently associated with death/transplant.",
    "title": "Outcomes with prophylactic use of percutaneous left ventricular assist devices in high-risk patients undergoing catheter ablation of scar-related ventricular tachycardia: A propensity-score matched analysis.",
    "xml": "<Element 'PubmedArticle' at 0x788501e5c5e0>"
}