ABSTRACT

Objectives:

We aim to investigate the local activation time (LAT) and local activation index as a new parameter in ablation of premature ventricular complexes (PVCs) arising from right and left ventricular outflow tract.

Materials and Methods:

The data of 90 patients who underwent successful ablation of PVCs originating from the right ventricular outflow tract (RVOT) and the left ventricular outflow tract (LVOT) between 2017 and 2019 were retrospectively reviewed. The clinical and demographic characteristics and electrophysiological parameters of the patients were compared. Clinical PVC LAT, catheter-induced PVC LAT and local activation index (clinical PVC LAT/catheter-induced PVC LAT), measured during ablation were compared between the groups.

Results:

A total of 90 patients, 45 of whom were in the RVOT and LVOT groups, were included in the study. The mean age was 43.1±14.9 years. There was no difference between the two groups in terms of age, gender, daily PVC burden, ejection fraction, procedure duration, and catheter-induced PVC LAT values. There was a significant difference between the two groups in terms of PVC QRS duration, clinical PVC LAT, and local activation index. Clinical PVC LAT was 30.9±3.4 m/sec in the RVOT group and 40.02±4.6msn in the LVOT group (p<0.0001). The local activation index was 0.97±0.05 in the RVOT group and 1.35±0.16 in the LVOT group (p<0.0001).

Conclusion:

LVOT PCVs had more negative LAT values and higher local activation index than RVOT PVCs in ablation procedure.

Keywords: Local Activation Time, RF Ablation, Right Ventricular Outflow Tract, Left Ventricular Outflow Tract, Premature Ventricular Complex

References

Ng GA. Treating patients with ventricular ectopic beats. Heart. 2006;92:1707-1712.

Zhong L, Lee YH, Huang XM, et al. Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions: a single-center retrospective study. Heart Rhythm. 2014;11:187-193.

Ling Z, Liu Z, Su L, et al. Radiofrequency ablation versus antiarrhythmic medication for treatment of ventricular premature beats from the right ventricular outflow tract: prospective randomized study. Circ Arrhythm Electrophysiol. 2014;7:237-243.

van Huls van Taxis CF,wijnmaalen AP, den Uijl DW, et al. Reversed polarity of bipolar electrograms for predicting a successful ablation site in focal idiopathic right ventricular outflow tract arrhythmias. Heart Rhythm. 2011;8:665-671.

Prystowsky EN, Padanilam BJ, Joshi S, et al. Ventricular arrhythmias in the absence of structural heart disease. J Am Coll Cardiol. 2012;59:1733-1744.

Santangeli P, Pieroni M, Dello Russo A, et al. Correlation between signal-averaged ECG and the histologic evaluation of the myocardial substrate in right ventricular outflow tract arrhythmias. Circ Arrhythm Electrophysiol. 2012;5:475-483.

Herczku C, Berruezo A, Andreu D, et al. Mapping data predictors of a left ventricular outflow tract origin of idiopathic ventricular tachycardia with V3 transition and septal earliest activation. Circ Arrhythm Electrophysiol. 2012;5:484-491.

Baman TS, Lange DC, Ilg KJ, et al. Relationship between burden of premature ventricular complexes and left ventricular function. Heart Rhythm. 2010;7:865-869.

Yamada T, Litovsky SH, Kay GN. The left ventricular ostium: An anatomic concept relevant to idiopathic ventricular arrhythmias. Circ Arrhythm Electrophysiol. 2008;1:396-404.

Latchamsetty R, Yokokawa M, Morady F, et al. Multicenter outcomes for catheter ablation of idiopathic premature ventricular complexes. J Am Coll Cardiol EP. 2015;1:116-123.

Klein LS, Shih HT, Hackett FK, et al. Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease. Circulation. 1992;85:1666-1674.

Comparison of Local Activation Time and Index in Ablation of Premature Ventricular Complexes Originating From Right and Left Ventricular Outflow Tract

ABSTRACT

References