Catheter ablation of PVCs and VT from the aortic cusps and commissures achieved acute elimination in 87% of procedures with no observed coronary artery injury, despite variable adjunct imaging use.
Observational (n=290)
Yes
Does the use of adjunct imaging (ICE and/or coronary angiography) during ventricular ablation from the aortic cusps and commissures affect procedural efficiency and safety in patients with PVCs/VT?
Adjunct imaging during aortic cusp and commissure ablation varies widely across centers and increases procedural time and fluoroscopy, but no coronary injuries were observed regardless of the imaging strategy used.
Introduction Catheter ablation of premature ventricular complexes (PVCs) and ventricular tachycardia (VT) arising from the aortic cusps and commissures is effective but performed near the coronary ostia, raising concern for coronary injury. Adjunct imaging with intracardiac echocardiography (ICE) and coronary angiography is variably used, and its incremental benefit remains uncertain.Methods We analyzed 311 ablation procedures performed in 290 patients across four high-volume centers in the United States and Switzerland. Imaging strategies were categorized as no adjunct imaging, ICE only, angiography only, or combined ICE plus angiography.Results Marked inter-center variability in imaging use was observed. Procedure duration and fluoroscopy exposure differed significantly by imaging strategy and were greatest when both ICE and angiography were used (p < 0.001). Acute elimination of targeted PVCs occurred in 87% of procedures. No coronary artery injury was observed.Conclusion Adjunct imaging strategies for aortic cusp and commissure PVC/VT ablation vary widely across centers and substantially influence procedural efficiency. Despite frequent ablation near the coronary ostia, no coronary injury events were observed.
Cecco et al. (Tue,) conducted a observational in Premature ventricular complexes and ventricular tachycardia (n=290). Intracardiac echocardiography (ICE) and/or coronary angiography vs. No adjunct imaging was evaluated on Acute elimination of targeted PVCs. Catheter ablation of PVCs and VT from the aortic cusps and commissures achieved acute elimination in 87% of procedures with no observed coronary artery injury, despite variable adjunct imaging use.