Transseptal vs Retrograde Aortic Ventricular Entry to Reduce Systemic Emboli

Exclusion Criteria

• •1. Planned epicardial ablation that would include a coronary angiogram (during the index ventricular tachycardia (VT) or premature ventricular contraction (PVC) catheter ablation procedure)
• •2. Any contraindication to MRI (as defined by the institution performing the MRI)
• •3. Clinical contraindication to a retrograde aortic approach as determined by the treating physician, including:
• •1. Severe aortic stenosis
• •2. Mechanical aortic valve
• •4. Clinical contraindication to a transseptal puncture as determined by the treating physician, including:
• •1. Severe Mitral valve stenosis
• •2. Mechanical Mitral valve
• •3. Atrial septal defect (ASD) or Patent foramen ovale (PFO) closure device that would preclude a transseptal puncture
• •4. Mitraclip or Alfieri mitral valve repair that would preclude a transseptal puncture
• •5. Planned or known need to perform either a retrograde aortic approach or transseptal approach (such as to target another site during the same procedure)
• •6. Inability to speak, read, and write in the English language at a 6th grade level (required for the Neurocognitive Function Testing)
• •7. Current mental impairment or other diagnosis which precludes accurate assessment of neurocognitive function or which may not allow patient to understand the nature, significance and scope of the study
• •8. Inability to perform neurocognitive function testing after \> 24 hours free of sedating medications