Catheter Ablation of Premature Ventricular Complexes Exclusively by A 3D Electroanatomic Pace-Mapping Software Technique: Long-Term Follow-Up

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Fabricio Vassallo, Edevaldo da Silva, Eduardo Serpa1, Rafael Zeni, Lucas Luis Meigre, Christiano Cunha, Hermes Carloni, Aloyr Simoes Jr., Carlos Lovatto, Karla Meira, Flávia Pezzin, Alberto Nogueira Jr., Dalton Amaral, Orly Lacerda Jr., Walter Batista Jr., Dalbian Gasparini

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Published: 10 October 2020 | Article Type :

Abstract

Introduction/Objective: Ablation of premature ventricular complexes (PVCs) is a challenge in routine electrophysiology. Results depend on factors such as location, tools, and technologies available. The study aimed to analyze the exclusive use of the pace-mapping technique with module of Score MapTM (SM) Software of Ensite Velocity/Precision and evaluate long term success.

Methods/Results: Forty-three procedures were retrospectively analyzed between March 2018 and August 2019. Ablation was conducted with an irrigated tip catheter with a power of 20–40 W and a pump flow rate of 30ml/min. Mapping with a duodecapolar was conducted in 36 (83.72%) cases, and the HDGrid catheter was used in seven (16.28%) cases. The patients included 22 (51.16%) females, and the mean age was 51.65 years (19–78). Thirty-five patients (81.40%) had hypertension; six (13.95%) had chronic coronary disease; four (9.30%) had myocarditis; two (4.65%) had diabetes; and none had implanted defibrillators. Mean ejection fraction was 63.17% (47.35%–77.32%). Average radiofrequency time was 597.72 (176–1356) s, and mean X-Ray time was 7.74 min. During the procedure, median SM was 93.81% (84%–100%) and only seven (18.42%) ablations were considered unsuccessful due to maintenance of extrasystoles or reduction of PVCs. After a follow-up of 19.58 (12–30) months, 37 (86.05%) patients achieved success. Failure was observed in cases with an SM score ≤ 92%, ablation cases with conscious sedation, female sex, both side ventricle ablation and associated with cardiac veins, and more than 900 seconds of RF application.

Conclusion: Score MapTM is useful as an exclusive technique for ablation of premature ventricular complexes with very good acute success and low complications, and an SM score higher than 92% had high long-term success. Failure was related to conscious sedation, female gender, both side ventricle with cardiac veins ablation, and longer radiofrequency time.

Keywords: Premature ventricular beats, catheter ablation, pace-mapping, electroanatomic mapping, activation map.

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Fabricio Vassallo, Edevaldo da Silva, Eduardo Serpa1, Rafael Zeni, Lucas Luis Meigre, Christiano Cunha, Hermes Carloni, Aloyr Simoes Jr., Carlos Lovatto, Karla Meira, Flávia Pezzin, Alberto Nogueira Jr., Dalton Amaral, Orly Lacerda Jr., Walter Batista Jr., Dalbian Gasparini. (2020-10-10). "Catheter Ablation of Premature Ventricular Complexes Exclusively by A 3D Electroanatomic Pace-Mapping Software Technique: Long-Term Follow-Up." *Volume 3*, 2, 17-25