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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/178455
Ventricular Extrasystole Ablation: electrophysiological characterization according to its origin
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Introduction. Premature Ventricular Complexes (PVCs) are a frequent nonsevere
cardiac condition that in some cases can be malignant, as they may result
in structural cardiomyopathies or even sudden death, and need treatment.
For pharmacoresistant PVCs, catheter ablation is used with a success rate
between 50-90% for PVC burden reduction.
The catheter used has a set of electrodes used to measure intracavitary signals.
Hypothesis and objectives. Electrophysiological characteristics of the PVCs
could be used to characterize the signals expected at different ventricular
structures and assess the outcome of the ablation in real-time.
Material and methods. Using CARTO3 (Remote Magnetic Navigation) we
studied 29 PVCs (24 patients), from the Arrhythmia Unit of the Hospital Clinic of
Barcelona. We characterized unipolar and bipolar electrograms by measuring
amplitudes, precocities and unipolar negative deflections, and the most
precocious isochrone at different cardiac points: Left ventricle (LV), Right
ventricle (RV), Pulmonary artery (AP), Summit(S) and cusps (C).
Results. Bipolar signals: the most precocious locations were RV and S,
differences between RV-S (24.2 ms vs 43.3 p=0.0017) and C-S (26.6 vs 43.3
p=0.0104). LV showed the largest bipolar amplitude (5.65 mV), S the lowest
(0.26).
Areas showing largest number of unipolar negative deflections were RV (n=1.43),
C (n=1.53) and AP (n=1.65), being significantly different form S (n=0.95, p=
0.0445, 0.0092, 0.00119, respectively).
The steepest slope at LV (0.3 mV/ms), flattest at S (0.0297), finding significant
differences LV-RV (p=0.0493).
Unipolar precocities were significantly different between RV (26.9 ms) and LV
(16.2, p=0.0002).
Conclusion. Relations can be found between intracavitary ablation signals and
ventricular structures. Differences in precocities between ventricles could be
used as a marker to assess the state of intervention.
More studies are needed to characterize ventricular substructures and to assess
the long-term outcome of the procedure.
Descripció
Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2020-2021. Tutor: Paz Garre Anguera de Sojo
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SOLÉ GALINDO, Eduard. Ventricular Extrasystole Ablation: electrophysiological characterization according to its origin. [consulta: 20 de gener de 2026]. [Disponible a: https://hdl.handle.net/2445/178455]