Arrhythmias & electrophysiologyResearch article
Intraseptal Mapping of Premature Ventricular Complexes Using Multipolar Catheters
- mapping and ablation experience
Authors' conclusion
Ablation of LVOT PVCs guided by intraseptal mapping using multipolar catheters is feasible and highly effective. Electrocardiogram predictors of SOO identify patients in whom intraseptal mapping may be useful. Reversal of late potentials with PVCs may represent abnormal substrate in idiopathic PVCs in ostensibly structurally normal hearts.
Study context
- Population
- Patients with suspected left ventricular outflow tract (LVOT) premature ventricular complexes (PVCs) in whom intraseptal mapping was attempted using multipolar cathetersmultipolar intraseptal mapping successfully performed in 60 (70%)
- Participants
- 86 patients
Main finding
As reported in the abstract
Successfully performed
60 (70%)
Female
30%
With prior ablation
53%
Further findings
Site of origin
- PVCs were most commonly mapped to an intramyocardial source and least commonly to the epicardium
ECG predictors of site of origin (SOO)
- LBBB PVCs: V2 S-wave pattern break (PB) ratio ruled in an intramyocardial or epicardial source
- >2.7
- LBBB PVCs: V2 S-wave PB ratio ruled out an endocardial source
- <1.2
- RBBB morphology PVCs: V2 R-wave PB ratio ruled out an endocardial source
- <1.0
Acute ablation success
- Acute ablation success
- 98%
Freedom from recurrence · median follow-up of 12.4 months
- Freedom from recurrence
- 93%
Intraseptal late potentials with reversal during PVC
- Observed
- 25 (42%) patients
- Associated with long-term success
Original publication
Summarised from the published abstract; every number is checked against it