Zhuo Liang1, Xuejun Ren1, Tao Zhang1, Zhihong Han1, Jianzeng Dong2, Yunlong Wang3. 1. Department of Cardiology, Beijing Anzhen Hospital affiliated to Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, China. 2. Department of Cardiology, Beijing Anzhen Hospital affiliated to Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, China. jz_dong@163.com. 3. Department of Cardiology, Beijing Anzhen Hospital affiliated to Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, 100029, China. wang76818@163.com.
Abstract
PURPOSE: We assessed conventional and reversed U curve methods for mapping and ablation of RVOT-type VAs. METHODS: Single-center data were reviewed from consecutive cases of symptomatic VAs of RVOT-type origin that were mapped and ablated successfully using conventional method in RVOT (pulmonary artery might be included) from January 2014 to December 2015 (cohort 1, n = 75) or conventional method in RVOT and reversed U curve in PSC (for first ablation attempt) from January 2016 to March 2017 (cohort 2, n = 60). RESULTS: At least 90% of RVOT-VAs could be eliminated using conventional method in RVOT or reversed U curve in PSC. For RVOT-VAs, if the earliest activation site was in midposterior free wall, midposterior septal side of RVOT, or anterior free wall/septal side of RVOT with conventional method, it was likely eliminated in right, left, and anterior PSC with reversed U curve method, respectively. Nearly the same earliest potential in almost the same region could be recorded by both methods. Compared with conventional method, the reversed U curve method showed better catheter stability and contact force during mapping and ablation, and showed distinctive features in presystolic potential recording, unipolar mapping, and ablation response. CONCLUSIONS: Most of RVOT-VAs could be eliminated using conventional method in RVOT or reversed U curve in PSC. However, the reversed U curve method has superiority in catheter stability and contact force, especially for VAs form free wall of RVOT.
PURPOSE: We assessed conventional and reversed U curve methods for mapping and ablation of RVOT-type VAs. METHODS: Single-center data were reviewed from consecutive cases of symptomatic VAs of RVOT-type origin that were mapped and ablated successfully using conventional method in RVOT (pulmonary artery might be included) from January 2014 to December 2015 (cohort 1, n = 75) or conventional method in RVOT and reversed U curve in PSC (for first ablation attempt) from January 2016 to March 2017 (cohort 2, n = 60). RESULTS: At least 90% of RVOT-VAs could be eliminated using conventional method in RVOT or reversed U curve in PSC. For RVOT-VAs, if the earliest activation site was in midposterior free wall, midposterior septal side of RVOT, or anterior free wall/septal side of RVOT with conventional method, it was likely eliminated in right, left, and anterior PSC with reversed U curve method, respectively. Nearly the same earliest potential in almost the same region could be recorded by both methods. Compared with conventional method, the reversed U curve method showed better catheter stability and contact force during mapping and ablation, and showed distinctive features in presystolic potential recording, unipolar mapping, and ablation response. CONCLUSIONS: Most of RVOT-VAs could be eliminated using conventional method in RVOT or reversed U curve in PSC. However, the reversed U curve method has superiority in catheter stability and contact force, especially for VAs form free wall of RVOT.
Entities:
Keywords:
Catheter ablation; Electrophysiology; Pulmonary sinus cusp; Reversed U curve; Right ventricular outflow tract; Ventricular arrhythmias
Authors: Christopher F Liu; Jim W Cheung; George Thomas; James E Ip; Steven M Markowitz; Bruce B Lerman Journal: Circ Arrhythm Electrophysiol Date: 2014-06-10