Outcomes For Radiofrequency Catheter Ablation Of Frequent Premature Ventricular Contractions And Analysis Of ECG Characteristics

Objective: This study aims to report the outcomes and complications of catheter radiofrequency ablation on frequent ventricular premature beats and evaluate the predictive factors of outcomes,and to determine the correlation between partial electrocardiographic features and the efficacy of catheter ablation.Materials and Methods: A total of 204 frequent ventricular premature patients who underwent radiofrequency catheter ablation in the Department of Cardiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,from January 1,2017 to July 31,2018,were included in the study(54.4% of women;the average age was 48±15 years old;the preoperative average number of PVCs were 22005±12735 beats/24 h.The basic medical information,electrocardiogram,accompanying diseases,target location and complications were collected through the electronic medical record system.Patients were followed up through telephone,and we asked them whether they take arrhythmia drugs or not at home and collected information about their ECG review.Statistical software(SPSS 21.0)were used to count the outcomes and complications of catheter radiofrequency ablation on frequent PVC,analyse the predictive factors of acute and clinical outcomes and ECG characteristics.Results: The acute procedural success was achieved in 85.8% of patients.Clinical success rate in patients without use of antiarrhythmic drugs was 85.4%,including patients who taking antiarrhythmic drugs after ablation,the clinical success rate was 81.7%.In multivariate logistic regression analysis,the predictors of acute success were right ventricular outflow tract(RVOT)PVC location and multifocal ventricular premature beat,and the only predictor of clinical success was a RVOT PVC location.The clinical success rate of radiofrequency catheter ablation in patients with structural heart disease was lower than that in patients without SHD(83.3%,vs 85.6%),but there was no statistical difference between them(P>0.05).The incidence of complications was 1.5%(1.0% for mild complications,0.5% for severe complications)and a mortality rate of 0.For patients without structural heart disease,there were no statistical differences between the success and failure groups about the ECG characteristics(PVC QRS width,MDI,notch in limb leads and precordial leads,s-wave in V5 or V6 lead).Conclusion: Radiofrequency catheter ablation is a safe and effective method for the treatment of frequent premature ventricular contractions.It can eradicate or significantly reduce the premature ventricular burden and improve the PVC-related symptoms of patients.The RVOT PVC location is an significant predictor of clinical success.There was no significant difference between SHD group and non-SHD group about the short-term clinical success rate.