Catheter ablation of PVCs and VT from the aortic cusps and commissures achieved acute elimination in 87% of procedures with no coronary artery injury observed, despite marked variability in imaging.
Observational (n=290)
Yes
Does the use of adjunct imaging (ICE and/or coronary angiography) during ablation of PVCs/VT from aortic cusps and commissures affect procedural efficiency and safety?
Adjunct imaging strategies during aortic cusp and commissure ablation vary widely and increase procedural duration and fluoroscopy exposure, though no coronary injury events were observed regardless of the strategy used.
ABSTRACT Introduction Catheter ablation of premature ventricular complexes (PVCs) and ventricular tachycardia (VT) arising from the aortic cusps and commissures is effective but performed near the coronary ostia, raising concern for coronary injury. Adjunct imaging with intracardiac echocardiography (ICE) and coronary angiography is variably used, and its incremental benefit remains uncertain. Methods We analyzed 311 ablation procedures performed in 290 patients across four high‐volume centers in the United States and Switzerland. Imaging strategies were categorized as no adjunct imaging, ICE only, angiography only, or combined ICE plus angiography. Results Marked inter‐center variability in imaging use was observed. Procedure duration and fluoroscopy exposure differed significantly by imaging strategy and were greatest when both ICE and angiography were used ( p < 0.001). Acute elimination of targeted PVCs occurred in 87% of procedures. No coronary artery injury was observed. Conclusion Adjunct imaging strategies for aortic cusp and commissure PVC/VT ablation vary widely across centers and substantially influence procedural efficiency. Despite frequent ablation near the coronary ostia, no coronary injury events were observed.
Cecco et al. (Tue,) conducted a observational in Premature ventricular complexes (PVCs) and ventricular tachycardia (VT) (n=290). Adjunct imaging (intracardiac echocardiography and/or coronary angiography) vs. No adjunct imaging, ICE only, angiography only, or combined ICE plus angiography was evaluated on Acute elimination of targeted PVCs. Catheter ablation of PVCs and VT from the aortic cusps and commissures achieved acute elimination in 87% of procedures with no coronary artery injury observed, despite marked variability in imaging.
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