The utility of 24-h electrocardiogram recordings for the prediction of a sufficient number of premature ventricular complexes and mapping strategy during catheter ablation.

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Frontiers in Cardiovascular Medicine Pub Date : 2025-03-05 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1558130
Stine Aagaard-Nilsen, Lars Andreas Dejgaard, Ole-Gunnar Anfinsen, Erik Lyseggen, Torbjørn Holm, Trine S Fink, Hans Henrik Odland, Knut Sevre, Erik Kongsgård, Finn Hegbom, Mathis Korseberg Stokke
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引用次数: 0

Abstract

Background and aims: An insufficient number of premature ventricular complexes (PVCs) during catheter ablation (CA) may prohibit adequate mapping of the site of origin. Parameters to predict this situation have not been established. Our objective was to quantify the association between preprocedural information and the probability of a sufficient number of PVCs for adequate mapping and successful CA.

Methods: Clinical characteristics and results from examinations and procedural data were collected retrospectively from health journals for patients admitted for CA of PVCs from 2011 to 2020.

Results: In total, 46 of 332 patients (14%) had an insufficient number of PVCs to enable adequate electroanatomical mapping. Patients with a sufficient number of PVCs had nominally more PVCs in the 24-h electrocardiogram (ECG), with a strong statistical trend [16,007 (6,509-26,205) vs. 8,332 (3,066-20,974), p = 0.055]. The receiver operator curve for a sufficient number of PVCs in 24-h ECGs had an area under the curve of 0.610 (95% CI 0.498-0.722, p = 0.055). The best predictive values were found at >10,000 PVCs per 24-h, with a positive predictive value of 67% and a negative predictive value of 57%. Patients for whom activation mapping was used as the sole mapping method had more PVCs in the 24-h ECG than did patients for whom pace mapping was added or used as an alternative [19,769 (10,564-30,526) vs. 15,237 (6,000-25,033), p = 0.022]. Neither acute outcome nor procedure time depended on the mapping strategy.

Conclusion: The number of PVCs in a 24-h ECG was moderately associated with the presence of a sufficient number of PVCs to perform electroanatomical mapping during CA. The presence of more PVCs in the preprocedural 24-h ECG was associated with the use of activation mapping as the sole mapping strategy.

在导管消融过程中,24小时心电图记录对足够数量的室性早衰复核的预测和定位策略的应用。
背景和目的:导管消融(CA)期间室性早衰复合体(PVCs)数量不足可能会妨碍对起源部位进行充分的定位。预测这种情况的参数还没有确定。我们的目的是量化术前信息与足够数量的室性早搏的概率之间的关系,以进行充分的定位和成功的CA。方法:回顾性收集2011年至2020年因室性早搏CA入院的患者的临床特征、检查结果和手术数据。结果:332例患者中有46例(14%)的室性早搏数量不足,无法进行充分的电解剖定位。室性早搏数充足的患者,其24小时心电图(ECG)上的室性早搏数名义上较多,具有较强的统计学趋势[16,007(6,509-26,205)对8,332 (3,066-20,974),p = 0.055]。24小时心电图中足够数量的室性早搏的受试者操作曲线曲线下面积为0.610 (95% CI 0.498-0.722, p = 0.055)。最佳预测值为每24小时100万次,阳性预测值为67%,阴性预测值为57%。使用激活映射作为唯一映射方法的患者在24小时心电图中比添加或使用起搏映射作为替代方法的患者有更多的室性早搏[19,769(10,564-30,526)对15,237 (6,000-25,033),p = 0.022]。急性预后和手术时间都不取决于作图策略。结论:24小时心电图中室性早搏的数量与CA过程中存在足够数量的室性早搏进行电解剖定位有一定的相关性。术前24小时心电图中较多室性早搏的存在与使用激活定位作为唯一的定位策略有关。
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来源期刊
Frontiers in Cardiovascular Medicine
Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.80
自引率
11.10%
发文量
3529
审稿时长
14 weeks
期刊介绍: Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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