Clinical Significance of Unipolar Electrogram and Bipolar Electrogram in Guiding Radiofrequency Ablation of Outflow Tract Ventricular Premature Contraction
10.3969/j.issn.1000-3614.2025.05.006
- VernacularTitle:单极电图和双极电图对指导流出道室性早搏射频导管消融术的临床意义
- Author:
Liqi GE
1
;
Xiaoqin HU
1
;
Fei LI
1
;
Wensu CHEN
1
;
Hui WEI
1
;
Quan ZHANG
1
;
Baixiang ZHANG
1
;
Chaoqun ZHANG
1
;
Zhirong WANG
1
;
Chengzong LI
1
Author Information
1. 徐州医科大学附属医院 心血管内科,徐州 221000
- Publication Type:Journal Article
- Keywords:
idiopathic ventricular arrhythmias;
ventricular outflow tract;
catheter ablation;
unipolar electrogram;
bipolar electrogram
- From:
Chinese Circulation Journal
2025;40(5):480-485
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:We evaluated the clinical significance of unipolar electrogram and bipolar electrogram in guiding radiofrequency ablation for outflow tract ventricular premature contractions(PVC).Methods:Data were collected from 78 patients who underwent successful radiofrequency ablation of PVC.Pre-procedure electrocardiogram showed a LBBB morphology on inferior leads.In the included patients,the right-side ablation was performed at first,and if the ablation failed,the left-side ablation was then performed.According to the location of the successful ablation target,they were divided into unilateral ablation successful group and bilateral ablation successful group.The differences in the earliest bipolar local activation to QRS(LATBi),unipolar-dV/dTmax to QRS(LATUni),and local activation time were compared between the two groups.Furthermore,the electrogram characteristics predicting bilateral ablation were explored.Results:Patients were divided into unilateral ablation group(n=57)and bilateral ablation group(n=21)according to the ablation site.There were statistically significant differences in LATBi(25[21,30]ms vs.14[10,24]ms),LATUni(7[0,17]ms vs.-23[-41,-11]ms),and ΔLATBi-Uni(15[11,25]ms vs.44[25,56]ms)between the unilateral ablation group and the bilateral ablation group(all P<0.05).Multivariate regression analysis suggested that LATBi,LATUni,and ΔLATBi-Uni were independent predictors of the need for bilateral ablation.There was no significant difference between left and right LATBi,LATUni and ΔLATBi-Uni in the bilateral ablation group.LATUni≤-1 was the most accurate parameter for predicting the need for bilateral ablation(AUC=0.941;specificity 80.7%;sensitivity 100%).Conclusions:LATUni≤-1ms is a useful indicator for predicting the need for bilateral PVC ablation in this patient cohort.
