Efficacy of electroanatomic mapping in the catheter ablation of premature ventricular contractions originating from the right ventricular outflow tract

Takumi Yamada, Yoshimasa Murakami, Naoki Yoshida, Taro Okada, Junji Toyama, Yukihiko Yoshida, Naoya Tsuboi, Masahiro Muto, Yasuya Inden, Makoto Hirai, Toyoaki Murohara, Hugh T. McElderry, Andrew E. Epstein, Vance J. Plumb, G. Neal Kay

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

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. Methods and 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.

Original languageEnglish (US)
Pages (from-to)187-194
Number of pages8
JournalJournal of Interventional Cardiac Electrophysiology
Volume19
Issue number3
DOIs
StatePublished - Sep 2007
Externally publishedYes

Keywords

  • Electroanatomic mapping
  • Premature ventricular contraction
  • Radiofrequency catheter ablation
  • Right ventricular outflow tract

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