Background: There are unique advantages and disadvantages in the choice of contact mapping (CM) versus noncontact mapping (NCM) systems during ablation of right ventricular outflow tract (RVOT) arrhythmias. This study compared acute procedural success and clinical outcomes in matched patients undergoing CM- versus NCM-guided RVOT ablation.
Methods: A total of 167 consecutive patients with idiopathic RVOT ventricular arrhythmias underwent NCM- or CM-guided ablation. Propensity scoring was used to match each patient undergoing NCM-guided ablation to one control patient undergoing CM-guided ablation.
Results: A total of 120 patients were included in this final analysis. If initial ablation was acutely unsuccessful in either group, patients crossed over to the other group. Ablation was acutely successful in 47 of 60 (78.3 %) patients in the NCM group and 55 of 60 (91.7%) in the CM group (P = .002). Thirteen NCM patients required CM and two CM patients crossed over to utilize NCM (P = .002). Procedural duration, fluoroscopy time, and dose in NCM were greater than that in CM (P < .05, respectively). However, procedural complications were not different between two groups. During a mean follow-up of 51 ± 20.6 months, 51 of the 60 NCM patients remained free of arrhythmia, while 48 of the 60 CM patients had no recurrent arrhythmias (P = .47).
Conclusion: Contact mapping, compared to NCM, is the superior initial technique to guide RVOT arrhythmia ablation due to a higher procedural success without the need to switch to alternative mapping techniques and shorter procedural and fluoroscopic times.
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http://dx.doi.org/10.1111/pace.13935 | DOI Listing |
Arrhythm Electrophysiol Rev
December 2024
Heart Rhythm Research Group, Division of Biomedical Sciences, Warwick Medical School, Clinical Sciences Research Laboratory Coventry, UK.
Functional substrate mapping has emerged as an essential tool for electrophysiologists, overcoming many limitations of conventional mapping techniques and demonstrating favourable long-term outcomes in clinical studies. However, a consensus on the definition of 'functional substrate' mapping remains elusive, hindering a structured approach to research in the field. In this review, we highlight the differences between 'functional mapping' techniques (which assess tissue response to the 'electrophysiological stress' using short coupled extrastimuli) and those highlighting regions of slow conduction during sinus rhythm.
View Article and Find Full Text PDFFront Cardiovasc Med
January 2025
Department of Cardiology, General Regional Hospital "F. Miulli", Bari, Italy.
Background: Cardioneuroablation (CNA) is a new approach to treat reflex syncope and functional bradyarrhytmias caused by autonomic imbalance. We report our experience using CNA.
Method: From September 2022 to July 2023, we took care of 21 patients (mean age 42 ± 21 years; 62% male) affected by reflex syncope or functional bradyarrhythmias.
Rev Port Cardiol
January 2025
Cardiology Department, Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Introduction And Objectives: Pulmonary vein (PV) isolation is one of the cornerstones of rhythm-control therapy for symptomatic atrial fibrillation (AF) patients. Pulsed field ablation (PFA) is a novel ablation modality that involves the application of electrical pulses causing cellular death, and it has preferential tissue specificity. In this study, we aimed to share a one-year single center experience of AF ablation with PFA.
View Article and Find Full Text PDFPacing Clin Electrophysiol
January 2025
Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin, USA.
Background: Concurrent Micra leadless pacemaker (Medtronic, Minneapolis, Minnesota) implantation and atrioventricular node (AVN) ablation has been shown to be feasible and safe in patients with symptomatic, drug-refractory atrial fibrillation (AF). However, major complications within the 30 days after concurrent Micra implantation and AVN ablation have been reported. We evaluated the efficacy and safety of the concurrent procedure at our institution.
View Article and Find Full Text PDFRev Cardiovasc Med
January 2025
Department of Echocardiography and Cardiology, The First People's Hospital of Changzhou, 213003 Changzhou, Jiangsu, China.
Background: This article focuses on the effect of body mass index (BMI) on cardiac structure and function in cases with non-valvular atrial fibrillation (NVAF). Only a few articles have investigated the relationship between BMI and the incidence of left atrial thrombus (LAT) or spontaneous echo contrast (SEC) in cases with NVAF.
Methods: This single-center retrospective study was conducted at The First People's Hospital of Changzhou.
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