scholarly journals An Improved Iterative Pace-Mapping Algorithm to Detect the Origin of Premature Ventricular Contractions

2020 ◽  
Author(s):  
Andony Arrieula ◽  
Hubert Cochet ◽  
Pierre Jaïs ◽  
Michel Haïssaguerre ◽  
Mark Potse
Keyword(s):  
Premature Ventricular Contractions ◽  
Mapping Algorithm ◽  
Pace Mapping

scholarly journals Role of the notched unipolar electrogram in guiding catheter ablation of frequent premature ventricular contractions originating from the ventricular outflow tract

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097763
Author(s):  
Li-Hong Huang ◽  
Ming-Yang Gao ◽  
Li-Jun Zeng ◽  
Bo-Qia Xie ◽  
Liang Shi ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Distribution Area ◽  
Premature Ventricular Contractions ◽  
Successful Ablation ◽  
Ablation Success ◽  
Pace Mapping ◽  
Unipolar Electrogram

Objective To investigate the value of a notched unipolar electrogram (N-uniEGM) in confirming the origin of premature ventricular contractions originating from the ventricular outflow tract (VOT-PVC) during mapping and ablation procedures. Methods This retrospective study enrolled consecutive patients with symptomatic idiopathic frequent VOT-PVCs that underwent radiofrequency ablation. The characteristics of the uniEGM of the successful ablation targets were analysed. N-uniEGM was defined as the uniEGM presenting a QS morphology with ≥1 steep notches on the downstroke deflection. All patients were followed-up for 3 months post-ablation. Results The study enrolled 190 patients with a mean ± SD age of 49.0 ± 15.3 years. N-uniEGMs were recorded in 124 of 190 (65.3%) patients. The N-uniEGM distribution area was limited to a mean ± SD of 0.8 ± 0.4 cm2. N-uniEGM showed consistency with the outcomes of activation mapping and pace mapping. Patients with an N-uniEGM had an ablation success rate of 98.4% (122 of 124) and their ablation times were significantly shorter than those without an N-uniEGM (7.6 ± 3.8 s versus 15.8 ± 8.8 s, respectively). The sensitivity and specificity of N-uniEGM in predicting successful ablation of VOT-PVCs were 72.6% and 91.7%, respectively. Conclusion N-uniEGM was a highly specific and moderately sensitive predictor of successful radiofrequency ablation in patients with VOT-PVCs.

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