The vortex of three-dimensional mapping with a centrifugal ventricular assist device.

Introduction Left ventricular assist devices (VADs) are increasingly utilized for mechanical support in medical therapy refractory advanced heart failure. Thirdand fouth-generation VADs have a miniaturized intrapericardial design. The HeartWare HVAD is FDA approved for bridge to transplantation, while the HeartMate 3, which has a similar design, remains investigational in the USA. These centrifugal pumps use magnetic levitation to both suspend and drive their impellers. As the body of the VAD is immediately adjacent to the inflow cannula at the apex, there is potential for interaction with electroanatomic mapping (EAM) systems used in electrophysiology due to interactions with the electromagnetic field of the VAD. Ventricular tachycardia ablation in patients with an HVAD has been previously described; however, the interaction between EAM systems and an HVAD has not. This issue has important clinical implications for the electrophysiologist.