Advanced Electroanatomic Mapping with the TriDeca™ Catheter in Left Ventricular Assist Device-associated Ventricular Tachycardia: A Report of Two Cases.

Ventricular tachycardia (VT) in patients with left ventricular assist devices (LVADs) poses significant procedural challenges for catheter ablation due to altered cardiac anatomy, mechanical interference, and hemodynamic instability. High-density (HD) mapping technologies may improve procedural efficacy and safety in this complex population. We present two cases of drug-refractory monomorphic VT in patients supported by HeartMate 3™ LVADs (Abbott, Chicago, IL, USA), successfully managed using the TriDeca™ HD linear mapping catheter (Stereotaxis, St. Louis, MO, USA). In both cases, precise localization of slow conduction zones and targeted substrate ablation resulted in sustained arrhythmia suppression without recurrence during follow-up. These cases highlight the value of advanced mapping systems in overcoming LVAD-related limitations and optimizing ablation outcomes.