Single catheter approach for treatment of premature ventricular contractions

Background

Catheter ablation has become one of the main treatment strategies in patients with premature ventricular complexes (PVC). The successful mapping and ablation can be performed with an ablation catheter without additional diagnostic catheters.

Hypothesis

We hypothesize that using a single catheter for PVC ablation may decrease complications, procedure time, and fluoroscopy exposure while maintaining comparable success rates.

Methods

Sixty-nine consecutive patients with PVC were treated with a single catheter approach compared to a historical cohort, in which a conventional setup was used. Propensity score matching was conducted with a 1:1 ratio. Outcome parameters included acute procedural success with elimination of all premature ventricular contractions after catheter ablation, procedural data as well as complication rates.

Results

Patients treated with a single catheter approach had shorter total procedure (60 minutes [IQR: 47,5–69,0 minutes] vs. 90 minutes [IQR 60–120 minutes]; p = 0.001) and fluoroscopy times (218 seconds [IQR: 110,5–446 seconds] vs. 310 seconds [IQR 190–640 seconds]; p = 0.012), which consecutively leads to a reduction of radiation exposure signified by a lower dose area product (155 cGycm² [IQR 74.4–334.5 cGycm²] vs. 368.4 cGycm² [IQR: 126–905.4 cGycm²]; p value 0.009). Acute procedural success rates were comparable in both groups (54 [84.3%] in the single catheter approach group and 58 [90.6%] in the conventional group; p: 0.287).

Conclusion

A single catheter approach for the treatment of PVC is associated with a reduction of procedure- and fluoroscopy time, as well as a lesser radiation exposure, while maintaining equivalent acute success and complication rates compared with a conventionally used catheter setup.