Detailed Electrode Catheter Positioning is Important for the Ablation of Outflow Tract Origin Ventricular Arrhythmias.
10.18501/arrhythmia.2017.027
- Author:
In Geol SONG
1
;
Sung Hwan KIM
;
Ju Youn KIM
;
Jeong Ho KIM
;
Yoo Ri KIM
;
Tae Seok KIM
;
Ji Hoon KIM
;
Sung Won JANG
;
Man Young LEE
;
Tai Ho RHO
;
Yong Seog OH
Author Information
1. Division of Cardiology, Heart center, Konyang University Hospital, Daejeon, Korea.
- Publication Type:Original Article
- Keywords:
Outflow Tract;
Premature Ventricular Contraction;
Catheter Ablation
- MeSH:
Arrhythmias, Cardiac*;
Catheter Ablation;
Catheterization;
Catheters*;
Electrodes*;
Fluoroscopy;
Follow-Up Studies;
Humans;
Methods;
Recurrence;
Tachycardia, Ventricular;
Ventricular Premature Complexes
- From:International Journal of Arrhythmia
2017;18(4):168-175
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Electroanatomical mapping using a three-dimensional (3D) system has high accuracy and improves the results of the ablation of outflow tract (OT) premature ventricular contraction (PVC) or ventricular tachycardia (VT) but imposes a considerable economic burden. Here, we compared detailed diagnostic catheterization and 3D mapping system for the ablation of OT PVC/VT. MATERIALS AND METHODS: Between June 2012 and February 2017, patients with symptomatic OT PVC/VT underwent radiofrequency ablation. Group 1 underwent detailed diagnostic catheterization (using circular and linear multielectrodes) without a 3D mapping system, while group 2 underwent diagnostic catheterization using a conventional 3D mapping system. Procedural success of PVC reduction, remaining symptoms, need for post-operative medications, and procedural time were evaluated. RESULTS: Ninety-eight OT PVC/VT cases were consecutively enrolled. The mean follow-up period was 17.7±14.5 months. Neither acute success rate (95% vs. 82%, p=0.06) nor a PVC reduction > 80% (84% vs. 87%, p=0.74) differed significantly between the two groups. The recurrence rates of PVC-related symptoms were similar (12% vs. 7%, p=0.06) between the groups, but the medication requirement for symptomatic PVC differed (12% vs. 29%, p < 0.01). The total procedure time of group 1 was shorter than that of group 2 (132±42 min vs. 157±47 min, p=0.01) and fluoroscopy time (24±15 min vs. 38±22 min, p < 0.01) and ablation time (528±538 sec vs. 899±598 sec, p < 0.01) were also significantly shortened. CONCLUSION: Detailed electrode catheter positioning is a safe and cost-effective method for the ablation of OT PVC/VT.
