Conclusion
To date, there are no ACC/AHA/HRS/EHRA recommendations regarding PVIs or
atrial arrhythmia ablations on mechanical circulatory support. Most of
the literature on mechanical support with Impella has been centered
around its use in hemodynamically unstable ventricular tachycardia
ablations.
The use of the Impella CP for PVI/PWI allows adequate time for exit
block testing and also posterior wall isolation with radiofrequency
ablation after antral cryoablation of the pulmonary vein. It frees the
operator’s mind to do thorough mapping and ablation with the assurance
that the patient is receiving adjustable support based on hemodynamic
demands during the procedure.