Arrhythmias & electrophysiologyCohort study
Anatomical vs. electrophysiological approach for ablation of premature ventricular contractions originating from the left ventricular summit (ISESHIMA-SUMMIT Study)
- Observational study
Authors' conclusion
Shorter anatomical distances between the epi-EAS and ECS, and between the epi-EAS and LMT ostium, predict a successful ECS ablation. The prematurity of the endo-EAS electrogram and a shorter interval between the epi-EAS and endo-EAS predicted a successful endo-EAS ablation.
Study context
- Population
- Patients with idiopathic ventricular arrhythmias (VAs) from the epicardial LV summit, EAS in the coronary venous system47 men
- Participants
- 58 patients
- Exposure
- Successful vs unsuccessful ablation at the endocardial closest site (ECS) and at the endocardial earliest activation site (endo-EAS)
- Outcome
- Predictors of successful ablation at the ECS vs at the endo-EAS
Main finding
As reported in the abstract
Predictors of successful ablation
- Successful ECS ablation vs Unsuccessful · optimal cut-off ≤12.6 mm
- Epicardial earliest activation site (epi-EAS)–ECS distance 10.2 ± 4.7 vs. 18.8 ± 5.3 mm; P < 0.001
- Successful ECS ablation vs Unsuccessful · optimal cut-off ≤24.0 mm
- epi-EAS–LMT ostial distance 20.3 ± 7.6 vs. 30.3 ± 8.4 mm; P = 0.005
- Successful endo-EAS ablation vs Unsuccessful · optimal cut-off ≥18 ms
- Endo-EAS electrogram preceding QRS 23 (8, 36) vs. 15 (0, 19) ms; P < 0.001
- Successful endo-EAS ablation vs Unsuccessful · optimal cut-off ≤9 ms
- epi-EAS–endo-EAS interval 6 (1, 8) vs. 22 (12, 25) ms; P < 0.001
Observational data: associations, not effects.
Further findings
Overall successful VA elimination
- VAs eliminated (8 coronary venous system (CVS), 8 ECS = endo-EAS, 11 ECS, 15 endo-EAS)
- 42 (72%)
Original publication
Anatomical vs. electrophysiological approach for ablation of premature ventricular contractions originating from the left ventricular summit (ISESHIMA-SUMMIT Study). Europace. Published 5 November 2024. doi:10.1093/europace/euae278
Summarised from the published abstract; every number is checked against it