New simplified technique for 3D mapping and ablation of right ventricular outflow tract tachycardia

Moeen A. Saleem, Scott Burkett, Rod Passman, Samer Dibs, Erica D. Engelstein, Alan H. Kadish, Jeffrey Goldberger

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To evaluate the safety and efficacy of using a circular multielectrode catheter for mapping and ablation of ventricular tachycardia (VT) or premature ventricular complexes (PVCs) from the right ventricular outflow tract (RVOT). Background: Three-dimensional (3D) mapping systems are commonly used for mapping and ablation of RVOT VT and PVCs. Newer catheters that are circular with multiple electrodes, such as the Lasso catheter, are capable of simultaneously recording from multiple points within a circumferential plane. Given the tubular structure of the RVOT, these catheters could be used for mapping tachycardias from the RVOT. Methods: A retrospective cohort study of patients undergoing radiofrequency (RF) ablation of RVOT VT or PVCs was performed. In group 1 (n = 7), mapping was performed with a single ablation catheter and fluoroscopy. In group 2 (n = 10), 3D mapping using ESI (n = 9) or CARTO (n = 1) was performed. In group 3 (n = 12), mapping was performed with a circular multielectrode catheter (n = 12). All ablations were performed with 4-mm tip catheters using RF energy. Results: Catheter ablation for RVOT VT (n = 15) or PVCs (n = 14) was performed on 29 cases in 26 patients, 9 males. Mean age was 35.9 years. In groups 1, 2, and 3, the mean number of lesions was 17.7 ± 7.7, 13.6 ± 7.7, and 18.2 ± 22.7 and the median number of lesions was 20, 13, and 5, respectively. There were no significant differences in the number of lesions, RF time, fluoroscopy time, procedure time, and acute success rate among the three techniques. There were three complications in group 2 and one in group 3. Conclusion: The use of a circular multielectrode catheter is as effective as the other standard available 3D mapping techniques, both in terms of procedural success and procedural characteristics. Additionally, because of the lower cost associated with using the circular multielectrode catheter approach, further evaluation should be performed to determine whether this is the most cost-effective approach to 3D mapping and ablation of RVOT tachycardias.

Original languageEnglish (US)
Pages (from-to)397-403
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume28
Issue number5
DOIs
StatePublished - May 1 2005
Externally publishedYes

Fingerprint

Tachycardia
Catheters
Ventricular Tachycardia
Ventricular Premature Complexes
Catheter Ablation
Fluoroscopy
Costs and Cost Analysis
Electrodes
Cohort Studies
Retrospective Studies
Safety

Keywords

  • Circular multielectrode catheter
  • Radiofrequency ablation
  • Right ventricular outflow tract
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

New simplified technique for 3D mapping and ablation of right ventricular outflow tract tachycardia. / Saleem, Moeen A.; Burkett, Scott; Passman, Rod; Dibs, Samer; Engelstein, Erica D.; Kadish, Alan H.; Goldberger, Jeffrey.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 28, No. 5, 01.05.2005, p. 397-403.

Research output: Contribution to journalArticle

Saleem, Moeen A. ; Burkett, Scott ; Passman, Rod ; Dibs, Samer ; Engelstein, Erica D. ; Kadish, Alan H. ; Goldberger, Jeffrey. / New simplified technique for 3D mapping and ablation of right ventricular outflow tract tachycardia. In: PACE - Pacing and Clinical Electrophysiology. 2005 ; Vol. 28, No. 5. pp. 397-403.
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AU - Burkett, Scott

AU - Passman, Rod

AU - Dibs, Samer

AU - Engelstein, Erica D.

AU - Kadish, Alan H.

AU - Goldberger, Jeffrey

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N2 - Objective: To evaluate the safety and efficacy of using a circular multielectrode catheter for mapping and ablation of ventricular tachycardia (VT) or premature ventricular complexes (PVCs) from the right ventricular outflow tract (RVOT). Background: Three-dimensional (3D) mapping systems are commonly used for mapping and ablation of RVOT VT and PVCs. Newer catheters that are circular with multiple electrodes, such as the Lasso catheter, are capable of simultaneously recording from multiple points within a circumferential plane. Given the tubular structure of the RVOT, these catheters could be used for mapping tachycardias from the RVOT. Methods: A retrospective cohort study of patients undergoing radiofrequency (RF) ablation of RVOT VT or PVCs was performed. In group 1 (n = 7), mapping was performed with a single ablation catheter and fluoroscopy. In group 2 (n = 10), 3D mapping using ESI (n = 9) or CARTO (n = 1) was performed. In group 3 (n = 12), mapping was performed with a circular multielectrode catheter (n = 12). All ablations were performed with 4-mm tip catheters using RF energy. Results: Catheter ablation for RVOT VT (n = 15) or PVCs (n = 14) was performed on 29 cases in 26 patients, 9 males. Mean age was 35.9 years. In groups 1, 2, and 3, the mean number of lesions was 17.7 ± 7.7, 13.6 ± 7.7, and 18.2 ± 22.7 and the median number of lesions was 20, 13, and 5, respectively. There were no significant differences in the number of lesions, RF time, fluoroscopy time, procedure time, and acute success rate among the three techniques. There were three complications in group 2 and one in group 3. Conclusion: The use of a circular multielectrode catheter is as effective as the other standard available 3D mapping techniques, both in terms of procedural success and procedural characteristics. Additionally, because of the lower cost associated with using the circular multielectrode catheter approach, further evaluation should be performed to determine whether this is the most cost-effective approach to 3D mapping and ablation of RVOT tachycardias.

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