Catheter ablation of intramural outflow tract premature ventricular complexes: a multicentre study

• DOI: 10.1093/europace/euad100
• Publication Date: 2023-04-25T12:26:21Z
• Authors: Matthew Hanson; Piotr Futyma; Weeranun Bode; Jackson J Liang; Carlos Tapia; Christian Adams; Łukasz Zarębski; Aleksandra Wrzos; Luis Saenz; Mouhannad Sadek; Daniele Muser; Adrian Baranchuk; Francis Marchlinski; Pasquale Santangeli; Fermin Garcia; Andres Enriquez
• Keywords: Ventricular outflow tract

Ablation of outflow tract ventricular arrhythmias may be limited by a deep intramural location the arrhythmogenic source. This study evaluates acute and long-term outcomes patients undergoing ablation premature complexes (PVCs).This multicenter series included with structurally normal heart or nonischemic cardiomyopathy PVCs defined by: (a) ≥ 2 following criteria: (1) earliest endocardial epicardial activation < 20ms pre-QRS; (2) Similar in different chambers; (3) no/transient PVC suppression at endocardial/epicardial site; (b) recorded septal coronary vein. Ninety-two were included, mean burden 21.5±10.9%. Twenty-six had previous ablations. All inferior axis, LBBB pattern 68%. In 29 (32%) direct mapping septum was performed using an insulated wire multielectrode catheter, 13 these cases within Most required special techniques (one more), including sequential unipolar 73%, low-ionic irrigation 26%, bipolar 15% ethanol 1%. Acute achieved 75% patients. Following procedure, reduced to 5.8±8.4%. The follow-up 15±14 months 16 underwent repeat ablation.Ablation is challenging; arrhythmia elimination 3/4 patients, non-conventional approaches are often necessary for success.