3D electroanatomical navigation system-guided catheter ablation for idiopathic right ventricular outflow tract premature ventricular contractions / 第二军医大学学报

ABSTRACT

Objective To explore the feasibility and effectiveness of 3D electroanatomical navigation system(CARTO3)-guided catheter ablation for idiopathic right ventricular outflow tract premature ventricular contractions(RVOT-PVCs). Methods A total of 49 consecutive patients with RVOT-PVCs undergoing catheter ablation were divided into two groups 3D group received CARTO3-guided ablation (n=29) and the conventional group received X-Ray-guided ablation (n=20). The operation time, X-ray fluoroscopy time, X-ray fluoroscopy exposure, cost, complication, successfully rates and recurrence rates were compared between the two groups. Results The immediate success rates were 100% (29/29) in the 3D group and 95% (19/20) in the conventional group. Complications were found in 3 cases in the conventional group and not found in the 3D group. Fluoroscopy time of 3D group was significantly shorter than that of the X-Ray group([1.3±3.6] min vs [44.2±28.2] min, P<0.01), and the radiation dose was also significantly lower than that of the X-Ray group ([93±242] mGy vs [3 919±2 309] mGy, P<0.01), but the 3D group had significantly higher cost compared with the X-Ray group (P<0.01). There was no significant difference in the total operation time lengths between the two groups. Twenty(69.0%) of the 29 cases in the 3D group avoided fluoroscopy entirely. Conclusion Our study indicates that CARTO 3 system is safe and effective in guiding ablation for patients with RVOT-PVCs; the method can greatly reduce fluoroscopy time and fluoroscopy dose, and in many cases non-fluoroscopic radiofrequency catheter ablation(RFCA)can be achieved.