Int J Arrhythm.
2017 Dec;18(4):168-175. 10.18501/arrhythmia.2017.027.
Detailed Electrode Catheter Positioning is Important for the Ablation of Outflow Tract Origin Ventricular Arrhythmias
- Affiliations
-
- 1Division of Cardiology, Heart center, Konyang University Hospital, Daejeon, Korea.
- 2Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Korea. oys@catholic.ac.kr
- 3Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Korea.
- 4Department of Cardiology, Pohang St. Mary's Hospital, Korea.
- 5Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Korea.
- 6Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, Korea.
- 7Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Korea.
- 8Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St. Paul's Hospital, Korea.
- 9Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, Korea.
- KMID: 2402564
- DOI: http://doi.org/10.18501/arrhythmia.2017.027
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.
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