Impact of a Pre-defined Pacemapping Protocol Use for Ablation of Infrequent Premature Ventricular Complexes: A Prospective, Multicenter Study.
B, Jáuregui ; D, Penela ; J, Fernández-Armenta ; J, Acosta ; C, Terés ; D, Soto-Iglesias ; E, Silva ; A, Ordóñez ; Antonio R, San ; A, Chauca ; JM, Carreño ; C, Scherer ; A, Berruezo
Resumen: Background
Pacemapping (PM) is a useful maneuver for aiding premature ventricular complex (PVC) ablation. Its standalone clinical value is still to be defined.
Objectives
The purpose of this study was to analyze the efficacy of a predefined PM protocol for low-burden PVC ablation, regardless of their site of origin (SOO) and the presence of structural heart disease.
Methods
This was a prospective, nonrandomized, multicenter study. The PM protocol was performed when <1 PVC/min was found. The “target area” was delimited by the 3 best matching points >94% correlation, and 3 radiofreqency (RF) applications were delivered.
Results
Of 185 patients, 105 (57%) underwent activation mapping, 60 (32%) were PM-guided, and 20 (11%) were canceled due to absence of PVCs. Baseline QRS, PVC burden, and outflow tract origin were independent predictors of PM-guided ablation. A higher proportion of right ventricular outflow tract SOO in the PM group (52% vs 40%; P = .03) was observed. Mean target area was 0.6 ± 0.9 cm2. Mean 10-ms isochronal area in local activation time (LAT)-guided procedures was higher (1.7 ± 2.3 cm2; P <.001). Mean number of PM matching points acquired was 39 ± 21 (range 6–98). Mean mapping and RF times were similar in both groups. However, significantly shorter procedural (53 ± 24 vs 61 ± 26 minutes; P = .04) as well as RF times (111 ± 51 vs 149 ± 149 seconds; P = .05) were needed in the PM group using the proposed protocol. Global clinical success reached 87% for the PM group and 90% (P = .58) the for LAT mapping group.
Conclusion
When LAT mapping is precluded, application of a PM-guided ablation protocol directed to >94% matching correlation target area is a more efficient alternative with comparable clinical results.
ed to >94% matching correlation target area is a more efficient alternative with comparable clinical results.
Idioma: Inglés
DOI: 10.1016/j.hrthm.2021.05.023
Año: 2021
Publicado en: HEART RHYTHM 18, 10 (2021), 1709-1716
ISSN: 1547-5271
Factor impacto JCR: 6.779 (2021)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 36 / 143 = 0.252 (2021) - Q2 - T1
Factor impacto CITESCORE: 10.1 - Medicine (Q1)
Factor impacto SCIMAGO: 2.402 - Physiology (medical) (Q1) - Cardiology and Cardiovascular Medicine (Q1)
Tipo y forma: Article (PostPrint)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material.
Exportado de SIDERAL (2026-01-07-18:53:13)
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Pacemapping (PM) is a useful maneuver for aiding premature ventricular complex (PVC) ablation. Its standalone clinical value is still to be defined.
Objectives
The purpose of this study was to analyze the efficacy of a predefined PM protocol for low-burden PVC ablation, regardless of their site of origin (SOO) and the presence of structural heart disease.
Methods
This was a prospective, nonrandomized, multicenter study. The PM protocol was performed when <1 PVC/min was found. The “target area” was delimited by the 3 best matching points >94% correlation, and 3 radiofreqency (RF) applications were delivered.
Results
Of 185 patients, 105 (57%) underwent activation mapping, 60 (32%) were PM-guided, and 20 (11%) were canceled due to absence of PVCs. Baseline QRS, PVC burden, and outflow tract origin were independent predictors of PM-guided ablation. A higher proportion of right ventricular outflow tract SOO in the PM group (52% vs 40%; P = .03) was observed. Mean target area was 0.6 ± 0.9 cm2. Mean 10-ms isochronal area in local activation time (LAT)-guided procedures was higher (1.7 ± 2.3 cm2; P <.001). Mean number of PM matching points acquired was 39 ± 21 (range 6–98). Mean mapping and RF times were similar in both groups. However, significantly shorter procedural (53 ± 24 vs 61 ± 26 minutes; P = .04) as well as RF times (111 ± 51 vs 149 ± 149 seconds; P = .05) were needed in the PM group using the proposed protocol. Global clinical success reached 87% for the PM group and 90% (P = .58) the for LAT mapping group.
Conclusion
When LAT mapping is precluded, application of a PM-guided ablation protocol directed to >94% matching correlation target area is a more efficient alternative with comparable clinical results.
ed to >94% matching correlation target area is a more efficient alternative with comparable clinical results.
Idioma: Inglés
DOI: 10.1016/j.hrthm.2021.05.023
Año: 2021
Publicado en: HEART RHYTHM 18, 10 (2021), 1709-1716
ISSN: 1547-5271
Factor impacto JCR: 6.779 (2021)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 36 / 143 = 0.252 (2021) - Q2 - T1
Factor impacto CITESCORE: 10.1 - Medicine (Q1)
Factor impacto SCIMAGO: 2.402 - Physiology (medical) (Q1) - Cardiology and Cardiovascular Medicine (Q1)
Tipo y forma: Article (PostPrint)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material. Exportado de SIDERAL (2026-01-07-18:53:13)
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Record created 2026-01-07, last modified 2026-01-07