Efficacy of electroanatomic mapping in the catheter ablation of premature ventricular contractions originating from the right ventricular outflow tract.
BACKGROUND
Mapping of premature ventricular contractions (PVCs) originating from the right ventricular outflow tract (RVOT) sometimes is not easy because of an unstable incidence and multiple foci of the PVCs. The aim of this study was to evaluate the effectiveness of electroanatomic mapping in catheter ablation of those PVCs.


RESULTS
One hundred patients with 134 RVOT origin PVCs were randomly allotted to undergo either conventional (group I; 50 patients with 65 PVCs) or electroanatomic mapping (group II; 50 patients with 69 PVCs). In group II, electroanatomic mapping of the RVOT was performed using auto-freeze maps in patients with frequent PVCs, and pace mapping was performed marking the pacing sites on the remap which was made by extracting the anatomic frame out of the baseline map during sinus rhythm in patients with infrequent PVCs. Successful ablation was achieved in 44 (88%) group I patients and 48 (96%) group II patients (p = 0.14). The fluoroscopy and procedure times and those per PVC morphology were all significantly shorter in group II than group I overall (p < 0.0001 for all comparisons), and in each patient group with infrequent PVCs, frequent PVCs or unstable PVCs (p < 0.05-0.0001). The number of RF applications and that per PVC was significantly smaller in group II than group I (5.3 +/- 1.8 vs 6.2 +/- 2.4, and 4.4 +/- 1.2 vs 5.2 +/- 2.1; p < 0.05).


CONCLUSIONS
The use of electroanatomic mapping may reduce the fluoroscopy and procedure times in the ablation of RVOT PVCs, but there is no evidence that it improves the overall efficacy of the procedure.
Yamada
Takumi
T
Division of Cardiovascular Diseases, Cardiac Rhythm Management Laboratory, University of Alabama at Birmingham, VH B147, 1670 University Boulevard, 1530 3rd Avenue S, Birmingham, AL 35294-0019, USA. takumi-y@fb4.so-net.ne.jp
Murakami
Yoshimasa
Y
Yoshida
Naoki
N
Okada
Taro
T
Toyama
Junji
J
Yoshida
Yukihiko
Y
Tsuboi
Naoya
N
Muto
Masahiro
M
Inden
Yasuya
Y
Hirai
Makoto
M
Murohara
Toyoaki
T
McElderry
Hugh T
HT
Epstein
Andrew E
AE
Plumb
Vance J
VJ
Kay
G Neal
GN
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D002404:Catheterization; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006329:Heart Conduction System; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic