Use of ventricular synchronized triggered atrial pacing to facilitate hemodynamic support during mapping and catheter ablation of ventricular vachycardia

Use of VSTAP to Facilitate Hemodynamic Support. The ablation of hemodynamically unstable ventricular tachycardia (VT) is challenging and frequently requires alternative mapping techniques or the use of percutaneous mechanical support devices. Loss of atrioventricular synchrony contributes to hemodynamic compromise during VT. In order to facilitate successful mapping and ablation of unstable VT, we employed ventricular synchronized triggered atrial pacing (VSTAP) at 50% of the RR interval. In this case, triggered atrial pacing permitted activation mapping and, subsequently, successful ablation of the patient's unstable VT. Thus, VSTAP is a readily available and noninvasive technique that may provide adequate hemodynamic support during catheter ablation of unstable VT.