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Catheter ablation of premature ventricular complexes with low intraprocedural burden guided exclusively by pace-mapping.
J Cardiovasc Electrophysiol ; 30(11): 2326-2333, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31424129
ABSTRACT

BACKGROUND:

Catheter ablation (CA) of idiopathic premature ventricular complexes (PVCs) is typically guided by both activation and pace-mapping, with ablation ideally delivered at the site of the earliest local activation. However, activation mapping requires sufficient intraprocedural quantity of PVCs. This study aimed to investigate the outcome of CA of infrequent PVCs guided exclusively by pace-mapping.

METHODS:

We retrospectively analyzed all patients undergoing CA of idiopathic PVCs between 2014 and 2017.

RESULTS:

Among 327 patients, 24 (7.3%) had low intraprocedural PVC burden despite isoproterenol, including two patients with zero PVCs, rendering activation mapping impractical/impossible. All 24 had a history of symptomatic PVCs. During ablation, a median of 27 (17-55) pace-maps were performed, with best median PASO score of 97 (96-98)%. A median of 12 (8.75-18.75) radiofrequency (RF) lesions were delivered with 11.4 (8.5-17.6) minutes of total RF time. Clinical success, defined as more than 80% reduction in the burden of previously frequent PVCs and/or absence of symptoms as well as any documented clinical PVCs among those with infrequent or exercise-induced PVCs, was achieved in 19 (79%) patients over 9.2 (2.0-15.0) months of follow-up.

CONCLUSIONS:

When activation mapping cannot be performed due to inadequate intraprocedural PVC burden, detailed pace-mapping can frequently identify the precise arrhythmia site of origin, thereby guiding successful CA.

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Aspecto clínico: Prognóstico Idioma: Inglês Revista: J Cardiovasc Electrophysiol Assunto da revista: Angiologia / Cardiologia / Fisiologia Ano de publicação: 2019 Tipo de documento: Artigo