Ablation with zero-fluoroscopy of premature ventricular complexes from aortic sinus cusps: A single-center experience

Abstract

Background: Catheter ablation of premature ventricular complexes from aortic sinus cusps (ASC-PVC) is a complex procedure that conventionally requires coronary catheterization (CC) to localize coronary artery ostium (CAO). Little published information is available on the mapping and ablation with zero-fluoroscopy (ZF) of ASC-PVC. The aim of the study was to determine the efficacy and safety of ASC-PVC ablation with a ZF approach guided by 3D intracardiac echocardiography integration in the electroanatomical mapping system (ICE 3D-EAM). Methods: This observational study included one patient cohort treated conventionally and another treated with ICE 3D-EAM-guided ZF ablation. Clinical, efficacy, and safety outcomes were evaluated acutely and at 3 months follow-up. Results: The study included 21 patients with ASC-PVC: 10 in the ZF group (age 49 ± 16 years, 60% males) and 11 in the control group (age 47 ± 15 years, 27% males). Fluoroscopy was not required for any patient in the ZF group. Acute success was obtained in 80% of the ZF group vs 55% of the control group (P =.36). The recurrence rate was 30% in the ZF group vs 27% in the control group (P = 1). One nonsevere complication was observed in the ZF group (P =.48). Conclusions: ZF catheter ablation of ASC-PVC guided by ICE 3D-EAM is feasible, effective, and safe.