Pace mapping using the premature ventricular contraction (PVC) method resulted in a significantly higher ablation success rate (82%) compared to the ventricular tachycardia (VT) method (33%) in patients with idiopathic right ventricular tachycardia.
Observational (n=26)
26 patients (mean age 41 years, 69% female) with idiopathic right ventricular tachycardia undergoing catheter ablation, followed for 3 months to 5 years.
Pace mapping using the premature ventricular contraction (PVC) method vs Pace mapping using the ventricular tachycardia (VT) method
Ablation success rate per session, p=<0.05
Absolute Event Rate: 82% vs 33%
p-value: p=<0.05
右室起源の特発性心室頻拍 (VT) に対するカテーテルアブレーション (CA) において, 選択すべき手技及び部位検索法を検討した.26例 (男8女18, 年齢41±13才) , 計31種のVTにおいて洞調律時にpace mapping (PM) と, VT中にaotivation sequence mapping (AM) を施行し至適部位を検索した.成功session (回) 並びに失敗回におけるPMの一致率, VT中の最早期興奮伝播時間 (EAT) を比較し, PM, AMのいずれが部位の同定に有用であったかを調べた.更にPMでは (1) VTと高頻度刺激波形を比較する従来の方法 (VT法) の他に (2) VTと同じ波形の心室期外収縮 (PVC) と低頻度刺激波形を比較する新しい方法 (PVC法) を試み, その優劣を検討した.26例中22例 (85%) , 31種中27種 (87%) でCAによりVTが消失した.成功した27種中26種ではPMで至適部位を同定しえた.PM一致率は失敗11回で11.1に対し, 成功27回で11.5と有意に高かった.VT法とPVC法では一致率に差を認めなかったが (11.3vs11.5) , CA成功率はPVC法で有意に高かった (33%vs82%) .EATは失敗回と成功回で差を認めなかったが, 成功部位のEATは他の部位より短かった.右室特発性VTではPace Mappingがアブレーション至適部位検索に有用で, PVC法がVT法より優れていた.
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Shiro Kamakura
Electrophysiology
Wataru Shimizu
Electrophysiology
Yoshiaki Okano
Iwate Medical University
Japanese Journal of Electrocardiology
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Kamakura et al. (Mon,) conducted a observational in Idiopathic right ventricular tachycardia (n=26). Pace mapping using the premature ventricular contraction (PVC) method vs. Pace mapping using the ventricular tachycardia (VT) method was evaluated on Ablation success rate per session (p=<0.05). Pace mapping using the premature ventricular contraction (PVC) method resulted in a significantly higher ablation success rate (82%) compared to the ventricular tachycardia (VT) method (33%) in patients with idiopathic right ventricular tachycardia.
synapsesocial.com/papers/6a1ff7f99d62e9997c04aad2 — DOI: https://doi.org/10.5105/jse.16.153
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