Key result
Spatial displacement of mapping points during premature ventricular contractions was significantly smaller by 1.33 mm for PVCs originating from the outflow tracts compared to non-outflow-tract origins.
Why the study?
The study aimed to describe and improve the understanding of spatial displacement during PVC mapping and assess options for correction using hybrid activation mapping.
Does hybrid activation mapping reveal significant spatial displacement during premature ventricular contractions in patients undergoing catheter ablation?
Observational (n=22)
No
Does hybrid activation mapping reveal significant spatial displacement during premature ventricular contractions in patients undergoing catheter ablation?
Mean Difference: -1.33 (95% CI -2.63–-0.03)
Absolute Event Rate: 3.2% vs 4.5%
p-value: p=0.045
May support spatial correction for non-outflow-tract PVCs; hypothesis-generating for ablation accuracy.
BACKGROUND: Hybrid activation mapping is a novel tool to correct for spatial displacement of the mapping catheter due to asymmetrical contraction of myocardium during premature ventricular contractions (PVC). The aim of this study is to describe and improve our understanding of spatial displacement during PVC mapping as well as options for correction using hybrid activation mapping. METHODS AND RESULTS: We analyzed 5798 hybrid mapping points in 40 acquired hybrid maps of 22 consecutive patients (age 63 ± 16 years, 45% female) treated for premature ventricular contractions (PVCs). Median PVC-coupling interval was 552 ms (IQR 83 ms). Spatial displacement was determined by measuring the dislocation of the catheter tip during PVC compared to the preceding sinus beat. Mean spatial displacement was 3.8 ± 1.5 mm for all maps. The displacement was 1.3 ± 0.4 mm larger for PVCs with non-outflow-tract origin compared to PVCs originating from the ventricular outflow tracts (RVOT/LVOT; p = 0.045). Demographic parameters, PVC-coupling-interval and chamber of origin had no significant influence on the extent of spatial displacement. CONCLUSION: Ectopic activation of the ventricular myocardium during PVCs results in spatial displacement of mapping points that is significantly larger for PVCs with non-outflow-tract origin. The correction for spatial displacement may improve accuracy of radiofrequency current (RFC)-application in catheter ablation of PVCs.
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Nies et al. (2022) conducted an observational in Premature ventricular contractions (n=22). Outflow-tract origin of premature ventricular contractions vs. Non-outflow-tract origin was evaluated on Spatial displacement of mapping points (MD -1.33 mm, 95% CI -2.63 to -0.03, p=0.045). Spatial displacement of mapping points during premature ventricular contractions was significantly smaller by 1.33 mm for PVCs originating from the outflow tracts compared to non-outflow-tract origins.
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