Key result
Score Map-guided catheter ablation of PVCs achieves an ~86% long-term success rate.
Why the study?
PVC ablation is challenging and outcomes depend on available tools, prompting an evaluation of long-term success using exclusively the Score Map pace-mapping software module.
Does catheter ablation exclusively using the Score MapTM pace-mapping technique improve long-term success in patients with premature ventricular complexes?
Observational (n=40)
No
Does catheter ablation exclusively using the Score MapTM pace-mapping technique improve long-term success in patients with premature ventricular complexes?
Exclusive use of the Score MapTM pace-mapping technique for PVC ablation yields high long-term success rates (86%), particularly when the SM score is >92%.
Supports Score Map pace-mapping for PVC ablation; hypothesis-generating and requires randomized confirmation.
INTRODUCTION/OBJECTIVE: Ablation of premature ventricular complexes (PVCs) is a challenge in routine electrophysiology. Results depend on factors such as location, tools, and technologies available. The study aimed to analyze the exclusive use of the pace-mapping technique with module of Score MapTM (SM) Software of Ensite Velocity/Precision and evaluate long term success.METHODS/RESULTS: Forty-three procedures were retrospectively analyzed between March 2018 and August 2019.Ablation was conducted with an irrigated tip catheter with a power of 20-40 W and a pump flow rate of 30ml/min.Mapping with a duodecapolar was conducted in 36 (83.72%) cases, and the HDGrid catheter was used in seven (16.28%) cases.The patients included 22 (51.16%)females, and the mean age was 51.65 years (19-78).Thirty-five patients (81.40%) had hypertension; six (13.95%) had chronic coronary disease; four (9.30%) had myocarditis; two (4.65%) had diabetes; and none had implanted defibrillators.Mean ejection fraction was 63.17% (47.35%-77.32%).Average radiofrequency time was 597.72 (176-1356) s, and mean X-Ray time was 7.74 min.During the procedure, median SM was 93.81% (84%-100%) and only seven (18.42%) ablations were considered unsuccessful due to maintenance of extrasystoles or reduction of PVCs.After a followup of 19.58 (12-30) months, 37 (86.05%)patients achieved success.Failure was observed in cases with an SM score 92%, ablation cases with conscious sedation, female sex, both side ventricle ablation and associated with cardiac veins, and more than 900 seconds of RF application.CONCLUSION: Score Map TM is useful as an exclusive technique for ablation of premature ventricular complexes with very good acute success and low complications, and an SM score higher than 92% had high long-term success.Failure was related to conscious sedation, female gender, both side ventricle with cardiac veins ablation, and longer radiofrequency time.
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Vassallo et al. (2020) conducted an observational in Symptomatic premature ventricular complexes (n=40). Catheter ablation guided exclusively by Score Map pace-mapping software was evaluated on Long-term success (absence of frequent PVCs at 12 months follow-up). Catheter ablation of premature ventricular complexes guided exclusively by Score Map pace-mapping software achieved an 86.05% long-term success rate at a median follow-up of 19.58 months.
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