Key result
Reversed S-curve technique with steerable sheath boosts free-wall tricuspid PVC ablation success to 100%.
Why the study?
The study was conducted to assess the safety and effectiveness of a novel catheter ablation technique compared with the traditional approach for PVCs originating from the free wall of the tricuspid annulus.
Does the reversed S-curve technique with a steerable sheath improve procedural success and reduce procedural time compared to the reversed C-curve technique in patients undergoing ablation for PVCs from the free wall of the tricuspid annulus?
Cohort (n=59)
Randomly assigned
Yes
Does the reversed S-curve technique with a steerable sheath improve procedural success and reduce procedural time compared to the reversed C-curve technique in patients undergoing ablation for PVCs from the free wall of the tricuspid annulus?
The reversed S-curve technique with a steerable sheath provides a highly effective and safe approach for the challenging ablation of PVCs originating from the free wall of the tricuspid annulus.
Answers are grounded in this paper and cite their sources.
May improve tricuspid annulus PVC ablation success; hypothesis-generating observational data requiring randomized confirmation.
BACKGROUND: This study aimed to assess the safety and effectiveness of a novel technique for catheter ablation in patients with premature ventricular contraction (PVC) from the free wall of tricuspid annulus (TV). HYPOTHESIS: We hypothesized that the novel technique is more efficacious than the traditional approach. METHODS: We retrospectively investigated 59 consecutive patients with PVC originating from the free wall of TV between January 2013 and November 2021. The patients were divided into two groups: the reversed S-curve technique group (RST, n = 26) and the reversed C-curve technique group (RCT, n = 33). The RST under the support of a steerable sheath was used in RST group, while the RCT under the support of a nonsteerable sheath was used in the RCT group. Systematic mapping and radiofrequency ablation were preferentially performed under the valve in all patients. RESULTS: Compared to the RCT group, total procedural time and fluoroscopic exposure time were significantly shorter in RST group. Two patients experienced cardiac tamponade in the RCT group, while no complications were observed in RST group (p = .498). The success rate was significantly higher in RST group compared to RCT group (81.9% vs. 100%, p = .029). Three patients in RCT group failed to ablate during the operation but were successfully ablated using the novel method. During regular follow-up, no patients in the RST group had a recurrence, while three patients in the RCT group did (p = .274). CONCLUSIONS: It suggests that the reserved S-curve technique, supported by a steerable sheath, is a feasible and effective method for ablating PVC originating from the free wall of TV.
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Chen et al. (2023) conducted a cohort in Premature ventricular contractions originating from the free wall of the tricuspid annulus (n=59). Reversed S-curve technique (RST) with steerable sheath vs. Reversed C-curve technique (RCT) with nonsteerable sheath was evaluated on Procedural success rate (p=0.029). The reversed S-curve technique with a steerable sheath achieved a 100% success rate compared to 81.9% with the conventional reversed C-curve technique for ablating PVCs from the tricuspid annulus free wall.
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