Ablation of multifocal premature ventricular contractions using automated pace-mapping software
Raphaël P Martins1, Karim Benali1, Vincent Galand1
1Univ Rennes, CHU Rennes, INSERM, Rennes, France.
Summary
Automated pace-mapping software effectively ablates multifocal premature ventricular complexes (PVCs). This strategy significantly reduces PVC burden, even when activation mapping is not feasible.
Area of Science:
- Electrophysiology
- Cardiac Arrhythmia Management
Background:
- Multifocal premature ventricular complexes (PVCs) present a significant challenge for ablation.
- Traditional activation mapping may be insufficient for less prevalent PVC morphologies.
Purpose of the Study:
- To evaluate the efficacy of an automated pace-mapping software-based strategy for ablating multiple PVC origins.
- To assess the success rate and long-term outcomes of this novel ablation approach.
Main Methods:
- Prospective enrollment of patients undergoing ablation for multifocal PVCs.
- Utilized spontaneous PVC templates and detailed pace-mapping to identify PVC origins.
- Performed ablation based on pace-mapping, even without direct activation points.
Main Results:
- Successfully targeted 47 PVCs in 21 patients using detailed pace-mapping.
- Achieved complete acute procedural success in 66.7% of patients.
- Demonstrated a significant reduction in PVC burden from 24.4% to 5.6% at follow-up (p<0.001).
- Observed significant PVC burden reduction even in cases with procedural failure or untargeted PVCs.
Conclusions:
- Quantitative morphology-matching software enables detailed mapping of individual PVC origins.
- Successful ablation is achievable using pace-mapping, irrespective of activation point acquisition.
- This automated pace-mapping strategy offers a viable solution for complex multifocal PVC ablation.
Keywords:
Ablação por cateterCatheter ablationElectrophysiologyEletrofisiologiaExtrassístole ventricularPace-mappingPremature ventricular contractionMore Related Videos
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