[The effectiveness of RF ablation of ventricular ectopic beats made using selected mapping techniques]
Tomasz Senderek1, Jacek Bednarek1, Jacek Lelakowski2
1The John Paul II Hospital in Kraków, Department of Electrocardiology.
Unlabelled:
Only several world-leading centers have summarized outcomes of invasive therapy of ventricular arrhythmia.
Aim:
The aim of the work is to compare the effectiveness of RF ablation of ventricular arrhythmia.
Materials And Methods:
183 patients (111 males, mean age 50 ± 17) underwent RF ablation of ventricular ecopic beats (VEB). Retrospective analysis of procedural protocols, in- and outpatient medical records was performed. RF ablation was done using electroanatomical CARTO system, Pacemapping or both methods (CARTO + Pacemapping).
Results:
Long-term ablation effectiveness was as follows: CARTO - success rate assessed during the ablation procedure was 84,4%; during post operation period follow-up 70,3%, and in long term followup 71,1%; Pacemaping-success rate assessed during the ablation procedure was 91,7%; during post operation period follow-up 83,3%, and in long term follow-up 75,0%; CARTO + Pacemaping - success rate assessed during the ablation procedure was 85,4%; during post operation period follow-up 70,8%, and in long term follow-up 77,1%. Mean amount of VEBs per day before ablation was 18750 ± 12560 (2435 to 50000) and after ablation 575 ± 428 (0 to 1550), p<0.001. Best results were achieved in cases where both mapping techniques were used in combination. Among clinical parameters affecting long-term ablation effectiveness, only hypertension was found to significantly decrease long-term effectiveness of VEB ablation. Only ablation temperature and energy affected long-term therapy effect significantly (p<0,0014; HR=0,84). After the ablation, there was improvement of the left-ventricular end-diastolic diameter and ejection fraction.
Conclusions:
Long-term success of ventricular extrasystoly ablation in combined method (CARTO+Pacemapping) was slightly higher compared in CARTO technique and in Pacemapping technique. Classic RF ablation is effective and safe, therefore it can be considered as first-line therapy. In ablation, precise localization of arrhythmic focus is the most important factor. Ablation temperature and energy were significantly correlated to long-term ablation effectiveness. After ventricular extrasystoly ablation, left ventricle ejection fraction increased and left ventricle end-diastolic diameter decreased. Hypertension significantly decreased long-term effectiveness of ventricular extrasystoly ablation.
