Non-invasive electrocardiographic mapping on the ward to guide ablation of premature ventricular contractions

Abstract

Premature ventricular contracts (PVCs) are commonly encountered in clinical practice, but their ablation can prove difficult. In 15 patients with idiopathic PVCs, non-invasive mapping system View Into Ventricular Onset ™ (VIVO) in combination with 12‑lead Holter monitoring on the ward accurately guided catheter ablation via the creation of 'electrical roadmaps' of ventricular activation. This allowed for better discussions of risks and benefits with the patient prior to the procedure, and is likely to have particular advantages for patients with a low PVC burden, multiple morphologies, or difficult to reach origins.

Clinical perspective: PERSONALISED APPROACH: A novel non-invasive mapping tool in combination with technology, such as 12 lead Holter monitoring, allows for individualised, accurate prediction of PVC origin outside the electrophysiology (EP) lab.

Non-invasive mapping: An "electrical road map" can be implemented into 3D electroanatomical mapping systems, shortening procedure times and resulting in excellent clinical outcomes.

Potential benefits: VIVO could be used to improve catheter ablation outcomes for patients with infrequent PVCs, multiple morphologies and/or difficult to reach origins.

Keywords: Catheter ablation; Non-invasive mapping; Remote navigation; Ventricular arrhythmia.