PMID- 28846152
OWN - NLM
STAT- MEDLINE
DCOM- 20180808
LR  - 20220408
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 40
IP  - 11
DP  - 2017 Nov
TI  - Ablation of the vanishing PVC, facilitated by quantitative morphology-matching 
      software.
PG  - 1227-1233
LID - 10.1111/pace.13186 [doi]
AB  - BACKGROUND: Ablation of cardiac arrhythmias in children and teenagers often 
      necessitates the use of anesthesia, which can suppress ventricular arrhythmias 
      (VAs), making it difficult to map the site of origin using activation time (AT). 
      Pace mapping, a technique employed to assist with VA origin localization, depends 
      on subjective comparison of paced and targeted QRS morphology. We assessed the 
      utility of a quantitative approach to paced QRS to VA morphology matching using 
      the PaSo software (Carto 3, Biosense Webster), to localize the VA site of origin. 
      METHODS: Twenty-four patients underwent 26 procedures for frequent VAs, 29 for 
      targeted VA. If AT mapping was precluded due to infrequent VA, pace mapping was 
      executed using the PaSo software, after regionalization based on targeted VA QRS 
      morphology. RESULTS: Subjects were aged 1-32 (mean 14 +/- 6) years; 10 were male. 
      Heart disease was present in six patients. PVC frequency prior to onset of 
      anesthesia was 15 +/- 16/min, decreasing to 0-1 PVC/min in 17 cases prior to 
      ablation. Arrhythmia localization was performed by AT mapping + PaSo (12) or PaSo 
      only (17). Pace mapping exhibited an intraventricular gradient of percent QRS 
      morphology match. Highest achieved QRS match averaged 96 +/- 2%. Successful 
      ablation (> 1-month follow-up) was achieved in 24/29 targeted VAs, 11/12 ablated 
      using AT and pace mapping, and 13/17 VA ablated using pace mapping only, 
      P  =  0.29. CONCLUSIONS: (1) Spontaneous VA frequency was markedly reduced 
      following anesthesia, despite catecholamine administration. (2) Notwithstanding 
      the ability to perform AT mapping, successful ablation can still be performed 
      using pace mapping only, facilitated by the PaSo software.
CI  - (c) 2017 Wiley Periodicals, Inc.
FAU - Moak, Jeffrey P
AU  - Moak JP
AUID- ORCID: 0000-0003-2488-6056
AD  - Division of Cardiology, Children's National Health System, Washington, DC, USA.
FAU - Sumihara, Kohei
AU  - Sumihara K
AD  - Division of Cardiology, Children's National Health System, Washington, DC, USA.
FAU - Swink, Jonathan
AU  - Swink J
AD  - Division of Cardiovascular Anesthesia, Children's National Health System, 
      Washington, DC, USA.
FAU - Hanumanthaiah, Sridhar
AU  - Hanumanthaiah S
AD  - Division of Cardiology, Children's National Health System, Washington, DC, USA.
FAU - Berul, Charles I
AU  - Berul CI
AD  - Division of Cardiology, Children's National Health System, Washington, DC, USA.
LA  - eng
PT  - Journal Article
DEP - 20170929
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
CIN - Pacing Clin Electrophysiol. 2018 Apr;41(4):436. PMID: 29457832
CIN - Pacing Clin Electrophysiol. 2018 Apr;41(4):437. PMID: 29457834
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Electrophysiologic Techniques, Cardiac
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Software
MH  - Treatment Outcome
MH  - Ventricular Premature Complexes/*physiopathology/*surgery
OTO - NOTNLM
OT  - PVCs
OT  - PaSo
OT  - ablation
OT  - activation mapping
OT  - pace mapping
OT  - ventricular tachycardia
EDAT- 2017/08/29 06:00
MHDA- 2018/08/09 06:00
CRDT- 2017/08/29 06:00
PHST- 2017/03/07 00:00 [received]
PHST- 2017/07/12 00:00 [revised]
PHST- 2017/07/14 00:00 [accepted]
PHST- 2017/08/29 06:00 [pubmed]
PHST- 2018/08/09 06:00 [medline]
PHST- 2017/08/29 06:00 [entrez]
AID - 10.1111/pace.13186 [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2017 Nov;40(11):1227-1233. doi: 10.1111/pace.13186. 
      Epub 2017 Sep 29.