Rainer G. H. Moosdorf
University Hospital Marburg, Germany
Title: Less invasive intraoperative Laser-VT-Ablation
Biography
Biography: Rainer G. H. Moosdorf
Abstract
While ventricular fibrillation is often induced by acute ischemia or the immediate sequelae of it, ventricular tachycardia are mostly due to a pathological substrate such as even small scars or inflammatory infiltrates. As a consequence, sole revascularization does influence ischemia induced arrhythmias while most VTs remain unchanged. In case of necessary cardiac surgery, especially for myocardial revascularization, an intraoperative mapping and laser-ablation of the identified foci is recommended. If larger scars or even aneurysms are present, an endocardial and epicardial ablation is performed and has demonstrated its high efficacy with a successrate of more than 90%. In case of only small scars or infiltrates, we refrain from opening the ventricle and only perform an epicardial mapping and deep ablation, which is even curative in more than half oft he cases without further need of an ICD implantation, as demonstrated in a study with > 30 patients. As the whole procedure is performed on the beating heart, it does not add to ischemic time and does not increase the risk significantly.Laser-VT-ablation is an effective, less invasive, curative therapy for patients with an indication for open heart surgery, especially coronary revascularization, and with documented VTs.