Acute and one year outcome of premature ventricular contraction ablation guided by contact force and automated pacemapping software

Background: Radiofrequency (RF) ablation is a well-established approach to treat premature ventricular contractions (PVC) and is associated with good outcomes. Aim: The present study sought to analyze the acute efficacy and 1-year outcomes of PVC ablation using RF technology with an approach based on automated pace-mapping and contact force (CF) information. Methods: Sixty-one consecutive patients (52.4% males, age 45.9 ± 12.5) underwent catheter ablation for symptomatic monomorphic PVC. All procedures were guided by a 3-dimensional mapping system; site of ablation was selected based on PASO™ aided pace-mapping; RF was started on the selected location when stable catheter position with >10 g of CF were obtained.The procedure was defined as acutely effective if the PVC was eliminated and it did not recur during within 30 minutes. Long-term efficacy was defined as a decrease by more than 95% at 1 year of the initial PVC burden at ECG Holter monitoring. Results: The PVC ablation was performed in the right ventricular outflow tract in 37 patients (60.7%), left ventricle in 15 patients (24.6%), coronary cusps in 6 patients (9.8%), right ventricle in 3 patients (4.9%); PVC ablation was acutely successful in 59 of patients (96.7%). At 1-year efficacy was obtained in 57 patients (93.4%). No major complications occurred. Mean procedural and fluoroscopy time were 94.5 ± 20.9 and 4.3 ± 2.5 minutes respectively. Conclusion: Premature ventricular contraction RF ablation mainly guided by PASO™ and CF showed high success rate in both acute and 1-year follow-up (96.7% and 93.4% respectively). The best efficacy cut-off for RF ablation of PVCs has been identified in presence of both PASO™ ≥95% and CF >10 g.