Strategies for Managing Difficult VT Cases: What to Do for the Urgent Case (Joint Session)-Strategies for Managing Difficult VT Cases: What to Do for the Urgent Case (Joint Session)

Video Transcription

Video Summary

The session, "Strategies for Managing Difficult VT Cases: What to Do for the Urgent Case," was an insightful exchange of knowledge among experts in heart rhythm management. Co-chaired by Leonard Ilkenoff and Rafalina, the discussion featured four significant presentations.<br /><br />Dr. Rado Lenarczyk from the Medical University of Silesia discussed managing electrical storms and ventricular arrhythmias using a case study of a 48-year-old woman with myocarditis. Key interventions included the use of non-selective beta-blockers, cardiac MRI for diagnosis, and consideration of the wearable cardioverter defibrillator for patient stability. Despite interventions, her situation necessitated further strategies like Impella support and waiting list placement for heart transplantation.<br /><br />The second presentation by Dr. Thorsten Lewalter focused on whether VT ablation during electrical storms should be limited to specialized centers. Citing a complex case, he emphasized the need for experience, advanced equipment, and thorough preoperative diagnostics, arguing that such procedures indeed require specialized, well-prepared centers.<br /><br />Dr. Philip Kukulich introduced Stereotactic Arrhythmia Radiotherapy (STAR), a non-invasive radiotherapy for VT ablation. Highlighting its global adoption and potential for transforming VT treatment, he noted its differing biological effects and potential future to treat not just arrhythmia but also heart inflammation.<br /><br />Lastly, Dr. Joshua Moss explored new energy sources for VT ablation beyond traditional RF, such as ultra-low temperature cryoablation, pulse field ablation, and high-intensity ultrasound. He noted their potential to create larger and deeper lesions, which could supplant RF in substrate homogenization procedures.<br /><br />Overall, the session underscored the evolving landscape of VT management, highlighting promising innovations and the need for specialized care.

Keywords

VT management

electrical storms

ventricular arrhythmias

non-selective beta-blockers

Stereotactic Arrhythmia Radiotherapy

heart transplantation

specialized centers

pulse field ablation

wearable cardioverter defibrillator

myocarditis