Cor Vasa 2021, 63(1):11-14 | DOI: 10.33678/cor.2020.114

Prognostic value of time dependent voltage abatement during remote magnetic navigation guided ablation in idiopathic right ventricular outflow tract arrhythmias

Raluca Sirbu Prisecarua, Leila Riahib, Bruno Schwagtenb
a European Hospital Polisano Sibiu, Izvorului no 1, Sibiu, Romania
b Cardiovascular Centre Middelheim, Antwerpen, Belgium

Backgrounds: We set out to evaluate if time related voltage abatement (dV/dt) of ventricular electrograms (EGM) during catheter ablation of idiopathic right ventricular outflow tract (RVOT) arrhythmias using the Stereotaxis Niobe II system is an efficient marker of long-term procedural success.

Methods: Twenty-six consecutive patients with acute success of RVOT ablation for premature ventricular contractions (PVCs) and/or ventricular tachycardia (VT) suggestive of RVOT origin were included. Late success was defined as freedom of ventricular ectopies originating from the RVOT after 3 months of follow-up without antiarrhythmic drugs (AAD).

Results: After 3-month follow-up 20 of 26 patients (77%) remained free of symptoms and arrhythmias (group 1) and recurrences occurred in 6 patients (23%) (group 2). 'Warming up' during RF applications occurred respectively in 85% and 83.33% of patients (p = 0.46), after a mean period (dt 2) of 4.72±9.42 vs 10.75±11.34 s (p = 0.045). The time intervals from the onset of RF delivery (t0) to significant voltage abatement (>90%) or reversal of EGM polarity (t1) between the two groups were: 9.11±5.11 vs 32.16±10.33 (p = 0.00006). dV/dt1 was 95.44±87.6 vs 23.5±16.97 μV/s (p = 0.024).

Conclusions: Time related voltage abatement of ventricular EGM together with time interval from onset of RF ablation to significant voltage abatement (>90%) or reversal of EGM polarity and time interval from RF delivery to onset 'warming up' are possible predictors of long-term success after RF ablation of idiopathic RVOT arrhythmias.

Keywords: Ablation, Long-term outcome, RVOT ectopies, Time related voltage abatement of ventricular EGM

Received: April 24, 2020; Revised: December 1, 2020; Accepted: December 7, 2020; Published: February 25, 2021  Show citation

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Prisecaru RS, Riahi L, Schwagten B. Prognostic value of time dependent voltage abatement during remote magnetic navigation guided ablation in idiopathic right ventricular outflow tract arrhythmias. Cor Vasa. 2021;63(1):11-14. doi: 10.33678/cor.2020.114.
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