A novel ablation strategy of premature ventricular contractions originating from summit guided by CartoUNIVU module

Clin Cardiol. 2020 Sep;43(9):963-967. doi: 10.1002/clc.23390. Epub 2020 May 19.

Abstract

Background: Premature ventricular contractions (PVCs) from left ventricular (LV) summit remain challenging for the risk of coronary artery injury. Computed tomographic or intracardiac echocardiography may be helpful, but both still have many limitations. CartoUNIVU module has rarely been used in PVC ablation.

Methods: A total of 22 patients (14 men: mean age 56.4 ± 13.3 years) with an electrocardiogram indication of summit PVCs were included in the two centers study. A novel strategy ablation with the Image Integration Module CartoUNIVUTM module was performed for all the patients with PVCs originating from LV summit area, especially to prevent the coronary artery injury.

Results: The procedure time was 78.6 ± 22.7 minutes, and the fluoroscopy time was 12.5 ± 3.1 minutes. The distance between the target and nearest coronary artery was 8.0 ± 3.1 mm. Three patients with the distance to the nearest coronary artery <5 mm. During a mean follow-up of 11.0 ± 1.7 months, 21/22 (95.5%) patients were free from clinical PVC. No coronary artery injury was detected in the all the ablation procedures.

Conclusion: The novel strategy ablation with the Image Integration Module CartoUNIVU module is safe and effective for PVCs originating from LV summit area, especially to prevent the coronary artery injury.

Keywords: catheter ablation; left ventricular summit; premature ventricular contraction; ventricular arrhythmia.

Publication types

  • Multicenter Study

MeSH terms

  • Action Potentials
  • Adult
  • Aged
  • Beijing
  • Catheter Ablation / adverse effects
  • Catheter Ablation / instrumentation*
  • Electrocardiography, Ambulatory
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Heart Rate
  • Heart Ventricles / physiopathology
  • Heart Ventricles / surgery*
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Retrospective Studies
  • Surgery, Computer-Assisted / adverse effects
  • Surgery, Computer-Assisted / instrumentation*
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left
  • Ventricular Premature Complexes / diagnosis
  • Ventricular Premature Complexes / physiopathology
  • Ventricular Premature Complexes / surgery*