Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5 |
||
Impact of Pacing Output and Cycle Length on QRS Morphology in Ablation of Premature Ventricular Contractions (PACE-MAP-Trial) | ||
J.-H. van den Bruck1, J. Wörmann1, A. Sultan1, K. Filipovic1, C. Scheurlen1, S. C. R. Erlhöfer1, Z. Arica1, S. Dittrich1, J.-H. Schipper1, D. Steven1, J. Lüker1 | ||
1Elektrophysiologie, Herzzentrum der Universität zu Köln, Köln; | ||
Background Pace mapping is an established technique to localize the origin of premature ventricular contractions (PVC). The QRS morphology induced by endocardial pacing is compared with a previously recorded template of the target arrhythmia. Based upon historic in-vitro models pacing at the arrhythmia’s coupling interval (CI) and stimulation threshold has become the gold standard in pace mapping.
Objective There is a paucity of data supporting pacing at the CI and stimulation threshold as the gold standard for pace mapping. In this prospective study, we sought to assess systematically the impact of variations of pacing output and cycle length on the resulting QRS morphology during pace mapping in the context of PVC ablation (NCT05061498).
Methods All patients undergoing ablation of idiopathic PVC were prospectively enrolled in this study. Pace mapping was performed using four different parameter settings: (1) A predefined fixed burst at maximum output (10V/2ms), (2) fixed burst at stimulation threshold, (3) coupling interval at maximum output and (4) coupling interval at stimulation threshold. Pacing cycle length (PCL) of the fixed burst was defined as follows: for a CI ≤450ms = PCL of CI+100ms and for a CI ≥450 = PCL of CI-100ms. Using an automated waveform comparison algorithm (Bard® LabSystem™ PRO software; Boston Scientific, MA, USA), the resulting QRS complexes were matched with the clinical PVC, and with the gold standard. For every parameter setting the mean of the matching percentage of three QRS complexes entered the analysis.
Results
Conclusion |
||
https://dgk.org/kongress_programme/jt2022/aP492.html |