Radiofrequency catheter ablation of ventricular tachyarrhythmia under navigation using EnSite array

Area of Science:

• Electrophysiology
• Cardiac Ablation
• Medical Devices

Background:

• The EnSite array (EA) system enables real-time virtual activation mapping for ventricular tachycardia (VT) and premature ventricular contractions (PVCs).
• Understanding the origin and mechanism of VT/PVC is crucial for effective treatment planning.

Purpose of the Study:

• To evaluate the safety and efficacy of EnSite array (EA)-guided radiofrequency catheter ablation (RFA) for treating ventricular tachycardia (VT) and premature ventricular contractions (PVCs).

Main Methods:

• Fifty-five patients with 79 VT/PVCs underwent EA-guided RFA.
• Virtual activation mapping identified VT/PVC origins in the right ventricle (RV) and left ventricle (LV).
• Radiofrequency catheter ablation (RFA) targeted critical conducting pathways identified by combined contact voltage and virtual activation maps.

Main Results:

• The majority of VT/PVCs originated from the RV (66/79), particularly the RV outflow tract (57/79).
• RFA successfully eliminated most focal PVCs and macroreentrant VTs.
• Acute procedural success was achieved in all patients, with a mean follow-up of 21 months showing sustained symptom freedom.

Conclusions:

• EnSite array (EA)-guided radiofrequency catheter ablation (RFA) is a safe and effective treatment for ventricular tachycardia (VT) and premature ventricular contractions (PVCs).
• The procedure's success is independent of the VT/PVC origin, mechanism, sustainability, hemodynamic status, or presence of underlying heart disease.