Predictors of Successful Radiofrequency Catheter Ablation of Premature Ventricular Complexes

Abstract

Abstract Introduction Patients with a high premature ventricular complexes PVC burden can benefit from catheter ablation, which is an effective and curative strategy for improving symptoms while simultaneously reducing PVC burden. Depending on the origin of the PVC, catheter ablation can be used as first-line therapy or as a last resort in cases of more rare origins when medication fails or is not tolerated/wanted. Aim The aim of this study is to determine the predictors of successful Radiofrequency catheter ablation of premature ventricular complexes. Participants &Methods A total of 100 patients with PVCs burden greater than 15% who were scheduled for conventional or 3D ablation at electrophysiology unit of Ain Shams University between 2018 and 2020 were included in the study. Success was defined as acute elimination of PVCs in Cath-lab with a 30 minutes waiting period and PVCs burden <3% on follow up Holter recording. Results The success rate was 83% among 100 patients (mean age 41.31 ± 17.69 years, 52% female patients), with 68% of the patients undergoing conventional ablations. Success was predicted by age (<58 years), outflow tract (OT) origin of PVCs, and the existence of a pre-QRS signal on the ablation catheter> 33 msec (Pvalue < 0.001).There was no statistical difference between conventional ablation and 3D ablation in this study regarding predictors of success. Conclusion Age, Origin of PVCs and pre-QRS signal are predictors of success of PVCs ablation. Abbreviations ECG: electrocardiogram; LVEF: left ventricular ejection fraction; LVOT: left ventricular outflow tract; PVC: premature ventricular contraction; RFCA: radiofrequency catheter ablation; RV: right ventricular/ventricle; RVOT: right ventricular outflow tract; OT: Outflow tract