Díaz Infante Ernesto, Cózar León Rocío, Borrego Isabel, Maldonado Josefa, Nieto Pilar, Cruz Fernández José María
Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen Macarena, Sevilla, España.
Rev Esp Cardiol. 2011 Dec;64(12):1198-201. doi: 10.1016/j.recesp.2011.05.016. Epub 2011 Aug 10.
Premature ventricular contractions originating in the right ventricular outflow tract may respond poorly to pharmacological treatment, and ablation using conventional fluoroscopically-guided systems may be complicated by the difficulty in inducing arrhythmias. We describe the use of a non-contact mapping system to ablate difficult-to-induce premature ventricular contractions originating in the right ventricular outflow tract. Five premature ventricular contractions sites in the right ventricular outflow tract were ablated in a prospective series of 4 patients. Patients had a poor quality of life and had not responded to antiarrhythmic drugs. A mean of 3 radiofrequency pulses per site was applied and mean application time was 113±15s. We achieved a 100% acute success rate and there were no complications. Patients were asymptomatic without drug therapy after a mean of 30±16 months of follow-up. The noncontact mapping system is highly effective in eliminating difficult to induce, isolated premature ventricular contractions.