Application of 20 pole catheter mapping method in radiofrequency catheter ablation of idiopathic right ventricular outflow tract ventricular arrhythmias

Abstract

Objective The purpose of this study was to evaluate the feasibility and effectiveness of radiofrequency ablation of idiopathic right ventricular outflow tract(RVOT)ventricular premature contraction(PVC)and ventricular tachycardia(VT)guided by multi-electrode high density mapping(HDM). Methods From January 2015 to December 2017, 266 PVC/VT patients with RVOT originated PVC/VT underwent radiofrequency catheter ablation in The First Hospital of Harbin Medical University were divided into HDM group(161 cases), and point-by-point mapping(PBP)group(105 cases). In HDM group, 20 polar electrodes were used to measure for high-intensity active sequence mapping(Livewire DuoDeca, St.Jude Medical, USA), and in PBP group 4 pole used to conduct sequential mapping.The success rate, the operation time and the parameters of the operation were observed. Results ①The success rate in HDM group was 98.8%(159/161), and in PBP group was 96.2%(101/105). These was no significantly difference.②The operation time was(29.2±4.4)minutes in HDM group, and was(61.6±17.8)minutes in PBP group(P<0.01). The mapping time was(6.3±2.2)minutes in HDM group, and in PBP was(20.3±5.4)minutes(P<0.01). Acquiring effective activation mapping point number in HDM group was 465±113, and in PBP group was 46±18, (P<0.01). ③X ray exposure time in group HDM was (6.6±1.9)minutes, and in group PBP was(11.7±4.2)minutes(P<0.01). X ray exposure dose in HDM group was(6.4±2.4)mGy, and in group PBP(8.7±1.6)mGy(P<0.01). Conclusion Using 20 electrode mapping catheter in the same time significantly increased the number of effective measurement points, ablation success rate and significantly shortened the operation time X-ray exposure time and dose. Key words: Catheter ablation; Right ventricular outflow tract; Ventricular arrhythmias; High density mapping