Spatial displacement on three-dimensional maps caused by rhythm differences in premature ventricular contraction...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Imaging

Background:

• Three-dimensional (3D) electroanatomic mapping is crucial for premature ventricular contraction (PVC) ablation.
• PVCs exhibit spatial displacement in 3D maps compared to sinus rhythm, complicating ablation targeting.
• Accurate identification of PVC origin is essential for successful ablation outcomes.

Purpose of the Study:

• To investigate the spatial displacement characteristics of PVC origins in 3D electroanatomic maps.
• To evaluate the therapeutic efficacy of the LAT-Hybrid function in correcting spatial displacement for PVC ablation.
• To compare PVC origin characteristics based on anatomical location.

Main Methods:

• Thirty-two patients undergoing PVC ablation were analyzed using parallel mapping and the LAT-Hybrid function.
• Ablation was performed at the optimal LAT-Hybrid identified location.
• PVC origins were categorized by location (RVOT, septum, LVOT/summit) and efficacy assessed by acute response and 6-month clinical outcomes.

Main Results:

• PVC origins showed a mean spatial displacement of 5.6 mm, with the septum exhibiting a smaller displacement.
• The PVC origin voltage was predominantly in the low voltage-transitional zone (60%).
• Ablation at the LAT-Hybrid identified site achieved a 95.4% pace map match and 96.9% acute success rate, with good 6-month clinical outcomes.

Conclusions:

• Spatial displacement in 3D maps, due to altered excitation propagation during PVCs, can lead to inaccurate origin identification.
• The LAT-Hybrid function effectively corrects spatial displacement, enabling precise localization for successful PVC ablation.
• This approach significantly improves ablation success and patient outcomes.