Distal-to-proximal delay for ablation of premature ventricular contractions.

Autor: Clementy N; Cardiology Department, University of Tours, Tours, France., Ancedy Y; Cardiology Department, University of Tours, Tours, France., Bisson A; Cardiology Department, University of Tours, Tours, France., Andre C; Cardiology Department, University of Tours, Tours, France., Pierre B; Cardiology Department, University of Tours, Tours, France., Fauchier L; Cardiology Department, University of Tours, Tours, France., Babuty D; Cardiology Department, University of Tours, Tours, France.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2019 Feb; Vol. 30 (2), pp. 205-211. Date of Electronic Publication: 2018 Dec 27.
DOI: 10.1111/jce.13807
Abstrakt: Introduction: Ablation of premature ventricular contractions (PVCs) has emerged as a safe and effective treatment in patients experiencing a high PVCs burden. Mapping of PVCs origin may sometimes be challenging. We sought to evaluate the accuracy of a new electrophysiological criterion, the distal-to-proximal (DP) delay, at localizing the optimal site for ablation of ventricular ectopic foci.
Methods and Results: Consecutive patients with ablation attempts of symptomatic PVCs were included. Prematurity and DP delay-that is, the time duration between the onset of ablation catheter distal bipolar electrogram and the onset of proximal bipolar electrogram-were measured at successful and unsuccessful ablation sites by three blinded experienced electrophysiologists. Mean DP delay at effective ablation sites (N = 30) was significantly higher than at ineffective sites ( N = 55) (23 ± 9 vs 11 ± 8 milliseconds; P < 0.0001). DP delay had good-to-excellent interrater reliability. A DP delay greater than or equal to 15 milliseconds had the highest accuracy at predicting a successful ablation site (sensitivity 0.97, the area under receiver operating characteristic curve 0.87; P < 0.0001).
Conclusion: DP delay is an additional, simple, and effective electrophysiological parameter to accurately localize PVCs foci.
(© 2018 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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