Key result
Noninvasive 3D mapping with ECVUE allows ~97% successful focal arrhythmia ablation without complications.
Why the study?
Does noninvasive 3D electrocardiomapping effectively localize focal arrhythmias and facilitate successful ablation in patients with symptomatic PVCs, ATs, or WPW?
Observational (n=33)
Yes
Does noninvasive 3D electrocardiomapping effectively localize focal arrhythmias and facilitate successful ablation in patients with symptomatic PVCs, ATs, or WPW?
Noninvasive 3D electrocardiomapping is a feasible and effective tool for preprocedural localization of focal arrhythmias, facilitating successful ablation with minimal intracardiac mapping.
Answers are grounded in this paper and cite their sources.
May support noninvasive mapping to guide focal arrhythmia ablation; hypothesis-generating and requires randomized validation before practice change.
INTRODUCTION: A noninvasive 3D mapping technique (ECVUE™, CardioInsight Inc., Cleveland) maps the origin and mechanisms of various arrhythmias without catheterizing the heart. METHODS: Thirty-three patients (3 centers, mean 45.0 ± 14.6 years,) with symptomatic premature ventricular complexes (24 PVCs), focal atrial tachycardias (2 ATs), and manifest accessory pathways (7 WPW syndromes) were prospectively explored using 3D, noninvasive bedside electrocardiomapping. The location of origin of the focal arrhythmia was first determined using noninvasive mapping. Subsequently, a stimulus artifact was delivered at this site to confirm and evaluate the precise location of the mapped focal origin. The procedural parameters and clinical efficacy were studied. RESULTS: Ablation was successful in 32/33 (97%) patients (PVCs: 13 right, 10 left, 1 septal; WPW: 3 left, 3 right; ATs: 2 left) without complications. The time from catheterization to permanent arrhythmia elimination/termination, RF duration, skin-to-skin procedural duration, and fluoroscopic exposure were median 16, 3.98, 71, and 11.9 minutes (for n = 29), respectively. At mean 24.7 ± 3.7 months of follow-up, 31 patients remain arrhythmia-free after a single procedure. One patient (right WPW syndrome) required repeat ablation 1 month later. One patient had recurrence of PVCs and is now deceased. The cumulative radiation (CT scan and fluoroscopy) exposure was median 7.57 mSv. CONCLUSION: ECVUE(TM) is a noninvasive tool allowing rapid preprocedural localization of focal arrhythmia and enables the electrophysiologist with highly specific information to direct RF delivery at the source of the arrhythmia with minimal intracardiac mapping.
No takes yet. Share an insight, caveat, or question.
Hocini et al. (2015) conducted an observational in Symptomatic premature ventricular complexes, focal atrial tachycardias, and manifest accessory pathways (n=33). Noninvasive 3D mapping technique (ECVUE) was evaluated on Ablation success. Noninvasive 3D mapping using ECVUE allowed successful focal arrhythmia ablation in 97% (32/33) of patients without complications, with 31 remaining arrhythmia-free at 24.7 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: