title: Voltage combined with pace mapping is simple and effective for ablation of noninducible premature ventricular contractions originating from the right ventricular outflow tract.
abstract: BACKGROUND
  Premature ventricular contractions (PVCs) from the right ventricular outflow tract (RVOT) can resist conventional mapping strategies. Studies regarding optimal mapping and ablation methods for patients with noninducible RVOT-PVCs are limited. We retrospectively evaluated the efficacy and safety of a novel mapping strategy for these cases: voltage mapping combined with pace mapping.
  
  
  OBJECTIVE
  METHODS: We retrospectively included symptomatic patients (n = 148; 76 males; age, 44.5 ± 1.4 years) with drug-refractory PVCs originating from the RVOT, who underwent radiofrequency catheter ablation (RFCA), and stratified them as Group 1 and Group 2. Group 1 patients had noninducible RVOT-PVCs, determined after programmed stimulation, burst pacing, and isoproterenol infusion (n = 21; 12 males; age, 39.5 ± 10.8 years). Group 2 patients had inducible PVCs. Group 1 patients were subjected to voltage mapping combined with pace mapping; Group 2 underwent conventional mapping. In all patients prior to RFCA, detailed 3-dimensional electroanatomic voltage maps of the RVOT were obtained during sinus rhythm using the CARTO system.
  
  
  RESULTS
  Patients from both groups had similar success and complication rates associated with the RFCA. In Group 2, 89% (113/127) experienced the earliest and the successful ablation points in the voltage transitional zone. During the follow-up (36 ± 8 months), patients from both groups suffered similar rates of PVC relapse (2/21 and 7/127, respectively; P = 0.826).
  
  
  CONCLUSIONS
  Voltage mapping combined with pace mapping is effective and safe for patients with noninducible RVOT-PVCs determined by conventional methods.
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Zefeng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Heping
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Peng
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Xuhua
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Can
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Ruiqing
authors.initials: R
authors.lastname: Dong
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Huikuan
authors.initials: H
authors.lastname: Gao
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Yongquan
authors.initials: Y
authors.lastname: Wu
mesh_terms: D000328:Adult; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*; D018879:Ventricular Premature Complexes / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D015646:Ventriculography, First-Pass / Q000379:methods
keywords: Radiofrequency catheter ablation; pace mapping; premature ventricular contractions; right ventricular outflow tract; voltage mapping