Premature ventricular contractions cause a position shift in 3D mapping systems: analysis, quantification, and...

Area of Science:

• Electrophysiology
• Cardiac Mapping
• Interventional Cardiology

Background:

• Premature ventricular contractions (PVCs) can cause dynamic position shifts within 3D cardiac mapping systems.
• Accurate anatomical targeting is crucial for successful PVC ablation.

Purpose of the Study:

• To investigate the magnitude of position shifts caused by PVCs in 3D mapping.
• To develop and evaluate a corrected mapping approach (hybrid LAT map) for PVC ablation.

Main Methods:

• Prospective enrollment of patients undergoing PVC ablation.
• Utilized a modified CARTO 3D mapping system to compare conventional LAT and hybrid LAT maps.
• Calculated position shifts between LAT, hybrid LAT, and pacemap locations.
• Performed radiofrequency ablation targeting the hybrid LAT position.

Main Results:

• A mean position shift of 8.9 mm was observed between conventional LAT and hybrid LAT positions.
• Targeting the hybrid LAT position resulted in acute abolition of PVCs in all patients.
• One-year follow-up showed a significant reduction in PVC burden from 16% to <1%.

Conclusions:

• PVCs induce significant position shifts in 3D mapping systems.
• The hybrid LAT mapping approach effectively corrects for these shifts.
• This corrected targeting strategy is highly efficient for achieving successful and durable PVC ablation.