Combining contact force and local impedance to treat idiopathic premature ventricular contractions from the outflow tracts: impact of ablation strategy on outcomes
Journal of Interventional Cardiac Electrophysiology, ISSN: 1572-8595, Vol: 66, Issue: 9, Page: 2011-2020
2023
- 2Citations
- 2Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Article Description
Background: Contact force (CF)-sensing catheters have not proved superior to standard catheters in the ablation of premature ventricular contractions (PVCs) from the right and left ventricular outflow tract (RVOT, LVOT). In this context, the utility of measuring local impedance (LI) is not known. We aimed to ascertain whether the use of a catheter combining LI and CF information was associated with superior outcomes in comparison with other catheter technologies. Methods: We compared three groups of 40 propensity-matched patients with PVCs from the OTs, ablated by means of different catheter technologies: a CF-plus LI-featured catheter, an LI-featured catheter, and a standard irrigated catheter. Results: The CF + LI group displayed a significantly lower risk of PVC recurrence than the standard ablation group (HR, 0.22; 95%CI, 0.07–0.71; p = 0.01). In the CF + LI group, LI drop and RF time were the only predictors of successful lesions (OR = 1.19, CI: 1.13–1.26, p < 0.001; OR = 1.06 CI: 1.01–1.07, p = 0.044, respectively). In the coronary cusps, unlike the RVOT/LVOT region, CF was not associated with LI drop (p = 0.48), and RF duration showed a linear relationship with LI drop (p < 0.001). Conclusions: The use of ablation catheters that combine CF and LI information is associated with increased success in the RF ablation of PVCs from the OTs. LI drop is the most important predictor of effective lesions, but its behavior depends on the ablation site: in the coronary cusps, unlike the RVOT/LVOT region, longer RF application times are needed in order to achieve LI drops associated with successful outcomes. Registry and registration no. of the study/trial: NCT03793998.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85150626776&origin=inward; http://dx.doi.org/10.1007/s10840-023-01528-6; http://www.ncbi.nlm.nih.gov/pubmed/36964415; https://clinicaltrials.gov/ct2/show/NCT03793998; https://link.springer.com/10.1007/s10840-023-01528-6; https://dx.doi.org/10.1007/s10840-023-01528-6; https://link.springer.com/article/10.1007/s10840-023-01528-6
Springer Science and Business Media LLC
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