{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T20:47:32Z","timestamp":1780519652419,"version":"3.54.1"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL159401"],"award-info":[{"award-number":["R01HL159401"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The use of a Left Ventricular Assist Device (LVAD) in patients with advanced heart failure refractory to optimal medical management has progressed steadily over the past two decades. Data have demonstrated reduced LVAD efficacy, worse clinical outcome, and higher mortality for patients who experience significant ventricular tachyarrhythmia (VTA). We hypothesize that a novel prophylactic intra\u2010operative VTA ablation protocol at the time of LVAD implantation may reduce the recurrent VTA and adverse events postimplant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We designed a prospective, multicenter, open\u2010label, randomized\u2010controlled clinical trial enrolling 100 patients who are LVAD candidates with a history of VTA in the previous 5\u2009years. Enrolled patients will be randomized in a 1:1 fashion to intra\u2010operative VTA ablation (<jats:italic>n<\/jats:italic>\u2009=\u200950) versus conventional medical management (<jats:italic>n<\/jats:italic>\u2009=\u200950) with LVAD implant. Arrhythmia outcomes data will be captured by an implantable cardioverter defibrillator (ICD) to monitor VTA events, with a uniform ICD programming protocol. Patients will be followed prospectively over a mean of 18\u2009months (with a minimum of 9\u2009months) after LVAD implantation to evaluate recurrent VTA, adverse events, and procedural outcomes. Secondary endpoints include right heart function\/hemodynamics, healthcare utilization, and quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The primary aim of this first\u2010ever randomized trial is to assess the efficacy of intra\u2010operative ablation during LVAD surgery in reducing VTA recurrence and improving clinical outcomes for patients with a history of VTA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.13073","type":"journal-article","created":{"date-parts":[[2023,7,29]],"date-time":"2023-07-29T06:55:18Z","timestamp":1690613718000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Design and characteristics of the prophylactic intra\u2010operative ventricular arrhythmia ablation in high\u2010risk LVAD candidates (PIVATAL) trial"],"prefix":"10.1111","volume":"28","author":[{"given":"David T.","family":"Huang","sequence":"first","affiliation":[{"name":"Division of Cardiology University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Gosev","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4628-6852","authenticated-orcid":false,"given":"Katherine L.","family":"Wood","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hima","family":"Vidula","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania Medical Center  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Marchlinski","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania Medical Center  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Supple","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Pennsylvania Medical Center  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandip K.","family":"Zalawadiya","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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