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Journal of Interventional Cardiac Electrophysiology

, Volume 19, Issue 3, pp 187–194 | Cite as

Efficacy of electroanatomic mapping in the catheter ablation of premature ventricular contractions originating from the right ventricular outflow tract

  • Takumi Yamada
  • Yoshimasa Murakami
  • Naoki Yoshida
  • Taro Okada
  • Junji Toyama
  • Yukihiko Yoshida
  • Naoya Tsuboi
  • Masahiro Muto
  • Yasuya Inden
  • Makoto Hirai
  • Toyoaki Murohara
  • Hugh T. McElderry
  • Andrew E. Epstein
  • Vance J. Plumb
  • G. Neal Kay
Article

Abstract

Background

Mapping of premature ventricular contractions (PVCs) originating from the right ventricular outflow tract (RVOT) sometimes is not easy because of an unstable incidence and multiple foci of the PVCs. The aim of this study was to evaluate the effectiveness of electroanatomic mapping in catheter ablation of those PVCs.

Methods and results

One hundred patients with 134 RVOT origin PVCs were randomly allotted to undergo either conventional (group I; 50 patients with 65 PVCs) or electroanatomic mapping (group II; 50 patients with 69 PVCs). In group II, electroanatomic mapping of the RVOT was performed using auto-freeze maps in patients with frequent PVCs, and pace mapping was performed marking the pacing sites on the remap which was made by extracting the anatomic frame out of the baseline map during sinus rhythm in patients with infrequent PVCs. Successful ablation was achieved in 44 (88%) group I patients and 48 (96%) group II patients (p = 0.14). The fluoroscopy and procedure times and those per PVC morphology were all significantly shorter in group II than group I overall (p < 0.0001 for all comparisons), and in each patient group with infrequent PVCs, frequent PVCs or unstable PVCs (p < 0.05–0.0001). The number of RF applications and that per PVC was significantly smaller in group II than group I (5.3 ± 1.8 vs 6.2 ± 2.4, and 4.4 ± 1.2 vs 5.2 ± 2.1; p < 0.05).

Conclusions

The use of electroanatomic mapping may reduce the fluoroscopy and procedure times in the ablation of RVOT PVCs, but there is no evidence that it improves the overall efficacy of the procedure.

Keywords

Right ventricular outflow tract Premature ventricular contraction Electroanatomic mapping Radiofrequency catheter ablation 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Takumi Yamada
    • 1
  • Yoshimasa Murakami
    • 2
  • Naoki Yoshida
    • 2
  • Taro Okada
    • 2
  • Junji Toyama
    • 2
  • Yukihiko Yoshida
    • 3
  • Naoya Tsuboi
    • 3
  • Masahiro Muto
    • 4
  • Yasuya Inden
    • 4
  • Makoto Hirai
    • 4
  • Toyoaki Murohara
    • 4
  • Hugh T. McElderry
    • 1
  • Andrew E. Epstein
    • 1
  • Vance J. Plumb
    • 1
  • G. Neal Kay
    • 1
  1. 1.Division of Cardiovascular Diseases, Cardiac Rhythm Management LaboratoryUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Division of CardiologyAichi Prefectural Cardiovascular and Respiratory CenterIchinomiyaJapan
  3. 3.Division of Cardiology, Nagoya Dai-ni Red Cross HospitalCardiovascular CenterNagoyaJapan
  4. 4.Department of CardiologyNagoya University Graduate School of MedicineNagoyaJapan

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