Intramural Needle Ablation for Ablation of Recurrent Ventricular Tachycardia

Inclusion Criteria:

Monomorphic ventricular tachycardia or incessant ventricular arrhythmia (defined as >20% of
beats due to ventricular arrhythmia including unifocal premature ventricular contractions
(PVCs ), couplets, nonsustained VT) that is causing a decline in LV ejection fraction to
less than 40%

Arrhythmia meet the following criteria:

1. Ventricular arrhythmia is recurrent and symptomatic

2. prior antiarrhythmic drug therapy has failed due to recurrent ventricular arrythmia,
toxicity, or intolerance

- Age 18 or older

- Left ventricular (LV) ejection fraction > 10% as estimated by echocardiography or
contrast ventriculography within the previous 90 days

- Failed prior VT or PVC ablation due to spontaneous recurrence of the arrhythmia
or frequent PVCs.

- Able and willing to comply with all pre-, post-, and follow-up testing and
requirements

- Signed Informed Consent

Exclusion Criteria:

- Patients with idiopathic VT defined as VT that originates from a region without
evidence of scar detected by MRI or voltage mapping in a patient without other
evidence of heart disease that is not causing significant depression of ventricular
function.

- Definite protruding left ventricular thrombus on pre-ablation echocardiography when LV
ablation is required.

- Thrombotic myocardial infarction within the preceding two (2) months.

- Other disease process that is likely to limit survival to less than 12 months.

- Class IV heart failure, unless heart failure is due to frequent or incessant VT.

- Contraindication to heparin.

- Allergy to radiographic contrast dye.

- Severe aortic stenosis

- Severe mitral regurgitation with a flail mitral valve leaflet.

- Significant congenital anomaly or medical problem that in the opinion of the principal
investigator would preclude enrollment into the study.

- Enrolled in another investigational study evaluating a drug or device.

- Unstable angina that is not due to frequent or incessant VT.

- Women who are pregnant.

- Thrombocytopenia (platelet count < 50,000) or coagulopathy.

- Acute non-cardiovascular illness or systemic infection.

- Cardiogenic shock unless it is due to incessant VT