3D Map Combined with Transthoracic Echocardiography for Ablation of Premature Ventricular Contractions/Ventricular
Gozal Mirzeyeva1, Matthias Heukäufer1, Sarah Janschel1
1Department of Internal Medicine B (Cardiology, Angiology, Pneumology and Internal Intensive Care Medicine), University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany.
Insights
Catheter ablation can cure ventricular arrhythmias from papillary muscles. Combining noninvasive transthoracic echocardiography with 3D mapping improves localization and success for these challenging premature ventricular contractions (PVCs).
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- Ventricular arrhythmias originating from papillary muscles present significant clinical challenges.
- Catheter ablation offers a potential cure but is often difficult due to anatomical complexity and localization issues.
Purpose of the Study:
- To investigate the efficacy of combining transthoracic echocardiography (TTE) with 3D mapping for guiding catheter ablation of papillary muscle-originating premature ventricular contractions (PVCs).
Main Methods:
- Utilized noninvasive transthoracic echocardiography (TTE) as a cost-effective imaging tool.
- Integrated TTE with 3D electroanatomic mapping systems.
- Performed catheter ablation guided by the combined imaging and mapping approach.
Main Results:
- Successful localization and ablation of papillary muscle-originating PVCs were achieved.
- TTE provided valuable noninvasive support for assessing the focus location.
- The combined approach facilitated precise catheter manipulation and ablation targeting.
Conclusions:
- Transthoracic echocardiography (TTE) in conjunction with 3D mapping is an effective strategy for guiding catheter ablation of papillary muscle ventricular arrhythmias.
- This integrated method enhances the success rate and addresses the challenges associated with these specific arrhythmias.
Abstract:
Ventricular arrhythmias originating from the papillary muscle of the ventricles are complex clinical problems. Catheter ablation has the potential to cure these arrhythmias. However, the procedure is usually challenging due to the specific anatomy, catheter instability and difficulty in localization of the origin of the arrhythmias. Intracardiac echocardiography (ICE) has been reported to be the suitable imaging method for assessing the location of focus in papillary muscles. We used transthoracic echocardiography (TTE), as a noninvasive cost-effective imaging supporting modality, in combination with 3D mapping to guide the exact localization and successful ablation of papillary muscle-originating premature ventricular contractions (PVCs).
