Evaluation of the effectiveness of interventional treatment of ventricular arrhythmias of rare localizations using non-invasive mapping

Abstract

Background. Atypical localization of the focus of ventricular arrhythmias is a rather difficult group for invasive mapping and subsequent radiofrequency ablation. Invasive electroanatomical mapping, multipolar electrophysiological electrodes in combination with electrophysiological study for searching an early zone of arrhythmia focus, and substrate mapping, are aimed to identifying critical areas of the arrhythmia contour. However, there are still situations in which arrhythmia cannot be eliminated, despite the use of these systems. The method of superficial non-invasive mapping of the heart seems to be relevant, which makes it possible to estimate the volume of surgery and select the necessary technology to eliminate arrhythmias.Aim. To compare the effectiveness of interventional treatment of patients with ventricular arrhythmias of atypical localization with and without the use of superficial non-invasive mapping.Methods. The study included 40 patients with ventricular arrhythmias of rare localization. The patients were divided into two groups. Group I included 21 patients who underwent non-invasive superficial and invasive electrophysiological cardiac mapping. Group II included 19 patients who underwent invasive electrophysiological cardiac mapping.Results. Over a follow-up period of 12 months, the freedom from arrhythmia in group I was 76%, in group II — 61%. The total operation time, duration and dose of fluoroscopy were less in group I compared to the group II.Conclusion. The study results demonstrated that the method of non-invasive surface mapping of the heart is highly effective in ventricular arrhythmias of atypical localization. The time of radiofrequency ablation, interventional intervention, fluoroscopy is lower with the use of superficial non-invasive mapping, compared with the control group. Received 13 July 2021. Revised 20 October 2021. Accepted 9 December 2021. Funding: This work is supported by a grant of the Russian Science Foundation (project No. 19-15-00406). Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: E.A. Artyukhina, A.Sh. RevishviliData collection and analysis: E.A. Artyukhina, M.V. Yashkov, E.V. Dedukh, I.A. Taymasova, A.Sh. RevishviliStatistical analysis: M.V. YashkovDrafting the article: E.A. Artyukhina, M.V. YashkovCritical revision of the article: E.A. Artyukhina, M.V. Yashkov, A.Sh. RevishviliFinal approval of the version to be published: E.A. Artyukhina, M.V. Yashkov, E.V. Dedukh, I.A. Taymasova, A.Sh. Revishvili