Catheter Ablation of Premature Ventricular Complexes Exclusively by a Pace-Mapping Software Technique: Feasibility of a Registry Study

Abstract

Introduction/Objective: Ablation of premature ventricular complexes a challenge in routine electrophysiology because results, depend on factors such as location, tools and technologies used. Aim of study was analyze exclusive use of pace-mapping technique with module of Score Map Software of Ensite Velocity/Precision and compare with success procedure, 7- and 30-days post-ablation. Methods/Results: Retrospectively analyzed 50 procedures in 47 symptomatic patients between January 2018 and February 2020. Ablation with irrigated tip catheter, power 40Watts, pump flow 30ml/min. Mapping with Duodecapolar in 40(80%) and HDGrid catheter in 10(20%). Female was 25 (53.19%), mean age 53.5years (19-78), hypertension 27 (57.45%), 7 (14.91%) coronary disease, 4 (8.51%) myocarditis, 2 (4.26%) Diabetes and 2 (4.26%) patients with an implanted defibrillator. Mean ejection fraction 63.17%. Average radiofrequency time was 580.58 seconds and mean XRay time 7.74min. Median SM was 93.92% and only 8 (16%) ablations were considered unsuccessful due to maintenance of extrasystoles or do not show a marked reduction on PVC at the end of the procedure. At 7- and 30-days follow up 9 (18%) and 7 (14%) patients had unsuccessful ablation. All patients had a Score <95%, underwent ablation with conscious sedation, majority female, most PVCs located in left ventricle and had more extensive ablation. Conclusion: Score Map is useful as exclusive technique for ablation of premature ventricular complexes with very good acute success and low complications. Score Map more than 95% had high success. Failure is related to conscious sedation, female gender, left ventricle ablation and longer radiofrequency time.