Abstract 17189: Prevalence and Relevance of Recurrent Premature Ventricular Complexes in the Pre-discharge Period Following Pvc Ablation
Background: Radiofrequency catheter ablation is widely-used to target frequent premature ventricular complexes (PVCs) in patients with and without structural heart disease, with reported ablation-success rate being in the 80% range. However the risk-factors that correlate with ablation-failure have not been defined yet. We aimed to assess the prevalence of recurrent PVCs in the immediate post-ablation period and their relevance in relation to the clinical outcome of catheter ablation of PVCs.
Methods: A consecutive series of 104 patients (age: 58±15 years, male 57%, LVEF 54±10.8) with frequent PVCs and without structural heart disease referred for catheter ablation at our center, were included in this prospective analysis. Successful ablation was defined as the absence of spontaneous or induced clinical PVC, both with or without isoproterenol at the end of the procedure. Arrhythmia burden was assessed at baseline and follow-up using 24-hour Holter recording. Telemetry was performed for at least 12 hours in the immediate post-ablation period. Ablation success was defined as ≥ 90% reduction of the initial PVC burden at 3-month follow-up.
Results: At baseline, the mean number of PVC morphologies was 1.4± 2.2 and the predominant PVCs commonly originated from right ventricular outflow tract [34 (32.6%)], coronary cusps [28 (27%)], interventricular septum [16 (15.3%)] and left ventricular outflow tract [13 (12.5%)]. Elimination of predominant PVCs was achieved in all patients. In the 12-hour post-ablation period, recurrence of PVCs was observed in 16 (15%) patients, which were transitory and never documented at follow-up monitoring. The most common sites of origin of these early PVCs were anterior cardiac veins, papillary muscles and mitral valve annulus. At follow-up, recurrence was reported in 5 of the 104 patients (4.8%) of which only one had early PVCs during the 12-hour post-ablation period.
Conclusions: Recurrence of PVCs in the immediate post-ablation period is transient and not indicative of the failure of the index procedure. Furthermore, pre-discharge PVCs do not demonstrate any definite correlation with the risk of late recurrence. This is most likely the result of myocardial irritation secondary to the trauma of the ablation procedure.
Author Disclosures: S. Mohanty: None. J. Burkhardt: None. C. Trivedi: None. C. Gianni: None. M.F. Gunes: None. Y. Gokoglan: None. A. Al-Ahmad: None. J. Sanchez: None. P. Hranitzky: None. G.J. Gallinghouse: None. R. Horton: None. L. Di Biase: Consultant/Advisory Board; Modest; biosense webster, hansen medical, st. jude medical, Atricure, Inc, EpiEP. A. Natale: Consultant/Advisory Board; Modest; Janssen Pharmaceuticals, Biosense webster, Medtronic Inc, St. Jude medical, boston scientific corp..
- © 2015 by American Heart Association, Inc.