Increased Risk of Complications with Left Ventricular Ablations?

JANUARY 26, 2017

Catheter ablation may be connected with brain lesions when it is performed on the left side of the heart, according to new research from UC San Francisco.

In a study of 18 patients scheduled for catheter ablation related to ventricular tachycardia (VT) or premature ventricular contraction (PVC), researchers noted a significantly higher rate of seemingly asymptomatic brain injury due to embolism among the patients whose therapy occurred on the left ventricle of the heart. The left ventricle supplies blood to the brain.

Left ventricular (LV) ablation was performed in 12 patients compared to a control group of 6 patients who underwent right ventricular (RV) ablation. Pre- and post-procedural brain magnetic resonance imaging (MRI) was performed on each patient within a week of the ablation, along with a complete neurological examination.

Overall, 7 of the 12 patients (58%) who underwent LV ablation experienced 16 brain embolisms combined, compared to zero patients who underwent the RV ablation. Seven of 11 patients (63%) who underwent a retrograde approach to their LV ablation developed at least one new brain lesion.

Whitman IR, Gladstone RA, Badhwar N, et al. Brain emboli after left ventricular endocardial ablation. Circulation. 2017; doi;CIRCULATIONAHA.116.025546.