Arrhythmias & electrophysiologyResearch article
Anatomical Approach from Aortic Sinus of Valsalva for Para-Hisian Premature Ventricular Contractions: Safety and Outcomes
- retrospectively analyzed
Authors' conclusion
Coronary cusp ablation incorporated into a stepwise, multi-site ablation strategy may be associated with better procedural outcomes for para-Hisian PVC ablation without compromising safety. Earlier activation and close anatomical proximity between the para-Hisian site and the cusp region predict successful ablation using this approach.
Study context
- Population
- Patients undergoing para-Hisian PVC ablationpatients undergoing para-Hisian PVC ablation
- Participants
- 114 patients
Main finding
As reported in the abstract
Acute procedural success
89 patients (78%)
Further findings
Coronary cusp ablation attempted, clinical success vs clinical failure cases
- Coronary cusp ablation attempted, clinical success vs clinical failure cases — Coronary cusp ablation attempted in total
- 35 patients (31%)
- Coronary cusp ablation attempted, clinical success vs clinical failure cases: P=0.005
Long-term clinical success (≥80% PVC reduction)
- Long-term clinical success among patients with acute success
- 52%
PVC response among the 35 patients undergoing cusp ablation
- Premature ventricular contractions (PVCs) terminated, among the 35 patients undergoing cusp ablation
- 49% (17/35)
- Transient suppression or morphological change of PVCs, additional, among the 35 patients undergoing cusp ablation
- 31% (11/35)
Predictors of successful cusp ablation
- Earlier activation at the cusp and close anatomical proximity between the cusp and the earliest activation site in the His bundle region
Safety
Conduction system injury
- Conduction system injury overall
- 31 patients
- Events during cusp ablation
- one
- predominantly during His bundle region ablation
Original publication
Summarised from the published abstract; every number is checked against it