scholarly journals Bipolar radiofrequency catheter ablation of premature ventricular contractions arising from the left ventricular summit

2020 ◽  
Author(s):  
Dimitrios Asvestas ◽  
Theodoros Xenos ◽  
Panos Vardas ◽  
Stylianos Tzeis
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Left Ventricular ◽  
Premature Ventricular Contractions ◽  
Bipolar Radiofrequency

scholarly journals Prospective use of ablation index for the ablation of right ventricle outflow tract premature ventricular contractions: a proof of concept study

EP Europace ◽  
2020 ◽  
Author(s):  
Alessio Gasperetti ◽  
Rita Sicuso ◽  
Antonio Dello Russo ◽  
Giulio Zucchelli ◽  
Ardan Muammer Saguner ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ejection Fraction ◽  
Right Ventricle ◽  
Radiofrequency Catheter Ablation ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Ejection ◽  
Free Wall ◽  
Premature Ventricular Contractions ◽  
Ablation Index

Abstract Aims Radiofrequency catheter ablation (RFCA) represents an effective option for idiopathic premature ventricular contractions (PVCs) treatment. Ablation Index (AI) is a novel ablation marker incorporating RF power, contact force, and time of delivery into a single weighted formula. Data regarding AI-guided PVCs RFCA are currently lacking. Aim of the study was to compare AI-guided and standard RFCA outcomes in patients with PVCs originating from the right ventricle outflow tract (RVOT). Methods and results Consecutive patients undergoing AI-guided RFCA of RVOT idiopathic PVCs were prospectively enrolled. Radiofrequency catheter ablation was performed following per-protocol target cut-offs of AI, depending on targeted area (RVOT free wall AI cut-off: 590; RVOT septum AI cut-off: 610). A multi-centre cohort of propensity-matched (age, sex, ejection fraction, and PVC site) patients undergoing standard PVCs RFCA was used as a comparator. Sixty AI-guided patients (44.2 ± 18.0 years old, 58% male, left ventricular ejection fraction 56.2 ± 3.8%) were enrolled; 34 (57%) were ablated in RVOT septum and 26 (43%) patients in the RVOT free wall area. Propensity match with 60 non-AI-guided patients was performed. Acute outcomes and complications resulted comparable. At 6 months, arrhythmic recurrence was more common in non-AI-guided patients whether in general (28% vs. 7% P = 0.003) or by ablated area (RVOT free wall: 27% vs. 4%, P = 0.06; RVOT septum 29% vs. 9% P = 0.05). Ablation Index guidance was associated with improved survival from arrhythmic recurrence [overall odds ratio 6.61 (1.95–22.35), P = 0.001; RVOT septum 5.99 (1.21–29.65), P = 0.028; RVOT free wall 11.86 (1.12–124.78), P = 0.039]. Conclusion Ablation Index-guidance in idiopathic PVCs ablation was associated with better arrhythmic outcomes at 6 months of follow-up.

Abstract 16072: Clinical Outcomes of Catheter Ablation for Left Ventricular Summit/intramural Premature Ventricular Contractions Comparing Conventional vs. Fluoroless Techniques

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jorge Romero ◽  
Juan C Diaz ◽  
Isabella Alviz ◽  
David Briceno ◽  
Chintan Trivedi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Side Effects ◽  
Catheter Ablation ◽  
Ionizing Radiation ◽  
Clinical Outcomes ◽  
Radiofrequency Catheter Ablation ◽  
Left Ventricular ◽  
Premature Ventricular Contractions ◽  
Acute Success

Introduction: Radiofrequency catheter ablation (CA) is the preferred treatment for premature ventricular contractions (PVCs). Ionizing radiation has major side effects for both patients and personnel in the electrophysiology laboratory. Fluoroless procedures are routinely performed for atrial fibrillation and simple PVC cases. Nonetheless, left ventricular (LV) summit/intramural PVCs cases are more challenging and clinical outcomes and complications have been poorly studied in this category with the use of fluoroless ablation. Hypothesis: We aimed to compare acute, long-term success rate and complications between fluoroless procedures versus standard approach for left ventricular (LV) summit/intramural PVCs. Methods: We conducted a retrospective analysis of patients who underwent PVC ablation under fluoroscopy and non-fluoroscopy at two institutions. Results: A total of 41 cases were enrolled (male: 61%; mean age: 55 ). Twenty-five cases underwent ablation under fluoroscopy whereas 16 underwent non-fluoroscopy ablation. Acute success was seen in 88% of non-fluoroscopy cases compared to 87.5% in the fluoroscopy group ( p = 0.9). The PVC recurrence at 12 months was similar between both groups (non-fluoroscopy: 15% vs Fluoroscopy: 18%) ( p = 0.9). No complications occurred in any group. Conclusions: Fluoroless CA is an emerging technique in the treatment of LV summit/intramural PVCs that appears to have similar clinical outcomes and complications compared to conventional fluoroscopic procedures.

scholarly journals Catheter ablation for ventricular arrhythmias using remote magnetic navigation in patients with reduced ejection fraction

2021 ◽  
Vol 27 (3) ◽  
pp. 99-102
Author(s):  
Mohamed Dardari ◽  
Alexandrina Nastasa ◽  
Corneliu Iorgulescu ◽  
Stefan Bogdan ◽  
Vlad Bataila ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ejection Fraction ◽  
Complication Rate ◽  
Ventricular Arrhythmias ◽  
Radiofrequency Catheter Ablation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Complete Elimination ◽  
Premature Ventricular Contractions ◽  
Ventricular Ejection Fraction

Objective. Radiofrequency catheter ablation is an effective treatment option for cardiac arrhythmias including complex and ventricular arrhythmias. Remote magnetic catheter navigation (RMN) has been developed as a novel way of approach aiming to improve outcome and reduce complication rate, and reduce radiation exposure for both operator and patient. Our aim was to compare success and complication rate in patients with or without severely reduced left ventricular ejection fraction (LVEF). Methods. We retrospectively analyzed all the patients (n = 98) which have undergone RMN in our center between 2015-2021. No selection criteria for RMN procedure have been applied. All clinical and paraclinical, as well as procedural data were collected. Patients were divided into two groups, with or without severely reduced LVEF ≤ 35%. CARTO system was used for 3D electroanatomic mapping. RMN was done using Niobe ES system and an open-irrigated magnetic ablation catheter. Success rate was defi ned by complete elimination of clinical arrhythmia. Non-inducibility following ablation was assessed in all patients presenting with any type of ventricular arrhythmia other than premature ventricular contractions. Testing for inducibility was done by ventricular programmed pacing with up to four extra-stimuli. The statistical analysis was performed using SPSS software. P-value < 0.05 was considered signifi cant. Results. Successful ablation with complete elimination of the clinical arrhythmia was achieved in 92.3% of the patients with severely reduced LVEF and in 88.1% of patients with LVEF > 35% (p = 0.73). Overall minor complication rate was 2.04% with spontaneous resolution. No major complications were reported. Non-inducibility was achieved in 56.4% of the patients with LVEF ≤ 35% and in 79.2% of the patients with LVEF >35% (p = 0.023). Conclusion. Radiofrequency catheter ablation using RMN is effective and safe regardless of the presence or not of a severely reduced LVEF.

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