Optimization of Outflow-Tract Ventricular Arrhythmia Ablation Using a Universal Right Ventricle Model.

Area of Science:

• Cardiovascular Medicine
• Electrophysiology
• Medical Technology

Background:

• Radiofrequency catheter ablation (RFCA) is standard for right ventricular outflow tract ventricular arrhythmias (RVOT-VAs).
• Traditional electroanatomical mapping (EAM) is manual, time-consuming, and carries a risk of cardiac perforation.
• Novel mapping methods are needed to improve efficiency and safety in RVOT-VAs ablation.

Purpose of the Study:

• To assess the safety, feasibility, and efficacy of using a universal RVOT 3D model for idiopathic RVOT-VAs ablation.
• To compare the outcomes of 3D model-guided ablation with conventional EAM.

Main Methods:

• A universal RVOT 3D model was created using DICOM image processing and 3D printing.
• Patients undergoing RVOT-VAs ablation were divided into a 3D model group (n=149) and an EAM control group (n=79).
• Procedural times, acute success rates, and follow-up outcomes were compared between groups.

Main Results:

• The 3D model group showed significantly shorter procedural times (38 ± 14 min vs. 80 ± 39 min) and RF times (251 ± 176 s vs. 503 ± 425 s) compared to the EAM group.
• Acute complete VA elimination was achieved in 89% of the 3D model group versus 82% in the EAM group (p=0.14).
• No significant difference in fluoroscopy time was observed; cardiac tamponade occurred only in the EAM group. Follow-up success rates were 87% (3D model) vs. 75% (EAM).

Conclusions:

• Universal RVOT 3D modeling is a feasible, safe, and effective alternative to conventional EAM for idiopathic RVOT-VAs ablation.
• This innovative approach reduces procedural duration, potentially improving patient outcomes and operator efficiency.