Zero fluoroscopy PVC ablation

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Premature ventricular complex(PVC) catheter ablation is required in a wide spectrum of the population.Ionizing radiation exposure in this procedure carries health risks,especially in young patients. In this prospective observational study we included 18 patients,submitted to PVC ablation without fluoroscopy between October 2018 and December 2020.Baseline characteristics of the population,acute success and complications derived from the procedure were evaluated,as well as recurrence rate during follow-up. Median age was 49.5 years. Most often cause of ablation were palpitations(77.8%),followed by reduced LVEF(16.7%) and dyspnoea(5.6%).33.3% had a cardiopathy,the most common was tachycardiomyopathy(66.7%).PVC burden pre-ablation was 25 ± 12.6%.The most frequent PVC origin was RVOT(66.7%)followed by LVOT(22.2%),mitral annulus(5.6%) and papillary muscles(5.6%). We used a 3D electroanatomical navigation system in all cases,intracardiac echocardiography in 88.9% and a contact force catheter for mapping(61%) and ablation(88.9%).The mean maximum radiofrequency power applied was 35 ± 5.7W(236.5s median time).Median number of applications was 5.5 and mean total procedural time was 198.6 ± 67.5 minutes.Median best prematurity was 28ms.We used isoprenaline in order to induce PVC in 77.8% of cases and suppression of PVC was achieved in 88.9%.There was only one complication(pericardial effusion without the need for pericardiocentesis).Median follow-up of 5 months,17.6% of recurrences(<80% reduction of PVC burden at 3 months),all them(3) from RVOT. In conclusion, the PVC ablation without fluoroscopy is a safe procedure with no major complications and good rates of success and recurrence in our experience. Baseline characteristics of the patientsMale6(33.3%)Female12(66.7%)Median age-yr.(range)49.5 (23-71)HTA6(33.3%)DM2(11.1%)Dyslipidemia3(16.7%)Smoking6(33.3%)LVEF median-(%)56.5%Treatment pre-ablationBeta blockers11(61.1%)No treatment6(33.3%)BB + flecainide/propafenone1(5.6%)1st column: Characteristics /2nd column: Patients included (N = 18) Abstract Figure 1