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International Journal of Arrhythmia 2017;0(0):
Detailed Electrode Catheter Positioning is important for the Ablation of Outflow Tract Origin Ventricular Arrhythmias
In Geol Song 1, Sung-Hwan Kim 2, Ju Youn Kim 3, Jeong Ho Kim 4, Yoo Ri Kim 5, Tae-Seok Kim 6, Ji-Hoon Kim 7, Sung-Won Jang 8, Man Young Lee 9, Tai-Ho Rho 8, Yong Seog Oh 2
1Division of Cardiology, Heart center, Konyang University Hospital, Daejeon, Korea
2Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
3Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary’s Hospital, Uijeongbu, Korea
4Department of Cardiology, Pohang St. Mary’s Hospital, Pohang, Korea
5Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Incheon St. Mary’s Hospital, Incheon, Korea
6Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Daejeon St. Mary’s Hospital, Daejeon, Korea
7Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St. Vincent’s Hospital, Suwon, Korea
8Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St. Paul’s Hospital, Seoul, Korea
9Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Yeouido St. Mary’s Hospital, Seoul, Korea
Corresponding Author: Yong Seog Oh ,Tel: 82-2-2258-1141, Fax: 82-2-591-1506, Email: oys@catholic.ac.kr
Received: October 10, 2017.  Accepted: December 9, 2017.
Abstract
Background and Objectives: Electroanatomical mapping using 3D system has high accuracy and improves the result for ablation of outflow tract (OT) premature ventricular contraction (PVC) or ventricular tachycardia (VT), but imposes a considerable economic burden. We compared detailed diagnostic catheterization and 3D mapping system for the ablation of OT PVC/VT.
Materials and Methods: Between June 2012 and February 2017, patients with symptomatic OT PVC/VT underwent radiofrequency ablation. Group 1 used a detailed diagnostic catheterization (using circular and linear multielectrode) without 3D mapping system and for group 2, a conventional 3D mapping system was used. Procedural success of PVC reduction, remaining symptoms, need for post-operative medications, and procedural time were evaluated.
Results: Ninety-eight OT PVC/VT cases were consecutively enrolled. The mean follow-up period was 17.7±14.5 months. Neither acute success rate (95% vs. 82%, P=0.06) nor PVC reduction of more than 80% (84% vs. 87%, P=0.74) did not show significant difference between two groups. Recurrences of PVC related symptoms were similar (12% vs. 7%, P=0.06) but medication requirement for symptomatic PVC did differ (12% vs. 29%, P <0.01) between two groups. The total procedure time of group 1 was shorter than group 2 (132 ± 42min vs. 157 ± 47min, P=0.01) and fluoroscopy time (24 ± 15min vs. 38 ± 22 min, P <0.01), ablation time (528±538 sec vs. 899±598 sec, P <0.01) were also significantly shortened.
Conclusion: Detailed electrode catheter positioning is safe and cost effective method for the ablation of OT PVC/VT.
Key Words: outflow tract; premature ventricular contraction; nonsustained ventricular tachycardia; catheter ablation
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Detailed Electrode Catheter Positioning is Important for the Ablation of Outflow Tract Origin Ventricular Arrhythmias  2017 December;18(4)