Background: Activation mapping is the best strategy to localize idiopathic premature ventricular contractions (PVCs) during catheter ablation (CA). Nonetheless, activation mapping requires a high burden of intraprocedural PVCs. Therefore, the use of pace-mapping has been proposed as an alternative when the PVC burden is low.
Objective: We sought the utility of pace-mapping in patients with low burden PVC who underwent ablation
Methods: We retrospectively analyzed all patients undergoing CA for idiopathic PVCs between 2016 and 2018 at our institution. Only those patients with low PVC burden (2000/24 hrs) underwent pace-mapping and were included in the study for further analysis.
Results: Among 220 patients who underwent CA for PVC during the study period, 22 patients (10%) were included (male: 46.7%; mean age: 44.7 ± 14). Despite the use of high dose isoproterenol, these patients presented a low PVC burden during the procedure. The best median PASO score was 96% ± 2. At 12-month follow-up, there was a 70% recurrence rate in this cohort.
Conclusion: The use of pace-mapping has been proposed when activation mapping cannot be performed due to suppressed PVCs. Our results demonstrated that although detailed pace-mapping localizes the origin of PVCs in patients with a low PVC burden, the long-term recurrence rate at 12 months continues to be high.