Efficacy of advanced pace mapping technology for idiopathic premature ventricular complexes ablation: Usefulness of pace mapping

Abstract

Catheter ablation is an effective treatment for premature ventricular complexes (PVCs). Activation mapping is accurate but requires PVCs at the time of the ablation. Pace mapping correlation (PMC) is a supplemental tool recently developed as an integrated module for an electroanatomical mapping platform. Our study sought to investigate whether pace mapping technology provides similar ablation results in patients with low versus high idiopathic PVCs burden at the time of ablation and the relationship between sites with the highest PMC and the earliest local activation time (LAT). A total of 59 consecutive patients underwent catheter ablation for idiopathic PVCs were enrolled. A total of 12/59 patients (20%) were classified in the low PVCs burden group (defined as < 2 PVCs/min) and 47/59 (80%) in the high PVCs burden group. The most common site of PVCs origin was the right ventricular outflow tract (RVOT) followed by aortic cusps, coronary sinus (CS), parahisian region and aorto-mitral continuity (AMC). Procedural and 1-month success rate were 95% and 87% respectively. PVCs burden at the time of ablation did not influence the success rate. The mean distance between the earliest LAT points and the highest PMC points was 7.8 ± 4.8 mm (Table 1). Pace mapping correlation is useful to accurately localize the origin of idiopathic PVCs irrespective of the initial PVCs burden and, combined with LAT, provides optimal ablation results. Success rate at midterm follow-up is higher when the origin of PVCs is located in the RVOT as compared to other locations.