Intramural Needle Ablation for Refractory Premature Ventricular Contractions

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Frequent premature ventricular contractions (PVCs) often necessitate catheter ablation.
• Deep intramural PVC foci can resist standard ablation techniques, leading to treatment failure.

Purpose of the Study:

• To evaluate the efficacy and safety of infusion needle ablation (INA) for PVCs refractory to conventional radiofrequency ablation.

Main Methods:

• INA was performed using a deflectable catheter with a 12 mm extendable needle under FDA-approved protocols.
• Radiofrequency ablation was delivered via the needle with saline infusion, targeting PVC foci identified by standard mapping.
• Efficacy was measured by PVC burden reduction, and safety by serious adverse events.

Main Results:

• Thirty-five patients underwent INA, with 71.4% achieving acute PVC elimination.
• At follow-up, 73.3% met the primary efficacy endpoint, significantly reducing PVC burden (median 0.8%).
• The primary safety endpoint occurred in 14.3%, including heart block, femoral artery dissection, and pericardial effusions.

Conclusions:

• Infusion needle ablation (INA) demonstrates effectiveness in eliminating frequent PVCs resistant to standard ablation.
• INA presents an acceptable safety profile for managing refractory PVCs.