Non-invasive localization of premature ventricular focus: A prospective multicenter study

Jonathan Chrispin, Alexander Mazur, Jeffrey Winterfield, Alireza Nazeri, Miguel Valderrabano, Harikrishna Tandri

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Accurate localization of premature ventricular contractions (PVC) focus is a prerequisite to successful catheter ablation. Objective: The objective was to evaluate the software View Into Ventricular Onset (VIVO) accuracy at locating the anatomical origins for premature ventricular contractions. The VIVO device noninvasively creates a model of the patient's heart and torso, with exact locations of 12‑lead ECG electrodes, and applies a mathematical algorithm from surface signals to determine the origin of the arrhythmia. We sought to compare the agreement between VIVO-predicted locations to invasive electroanatomical mapping results. Methods: 51 consecutive patients who presented for PVC ablations at the study centers were recruited. VIVO images were collected at baseline preprocedure and all patients underwent invasive electroanatomical activation mapping of the clinical arrhythmia. Pacing was performed in pre-specified locations in the right and/or left ventricle. The successful sites of ablation and the pacing locations were compared to VIVO predicted locations. The results were adjudicated by physician experts in a blinded fashion. Results: Seven patients were excluded from analyses. VIVO accurately identified the origin of the clinical premature ventricular contractions in 44/44 patients (100.00%). The accuracy in identifying the paced location for all patients (right and left sides of the heart) was 99.5% using the VIVO system. No adverse events were reported. Conclusions: VIVO is a novel noninvasive system that could be used to help guide ablation procedures with a high degree of accuracy. The VIVO algorithm is easy to use and may be useful in the workflow for ventricular arrhythmia ablation.

Original languageEnglish (US)
Pages (from-to)6-12
Number of pages7
JournalJournal of Electrocardiology
Volume72
DOIs
StatePublished - May 1 2022

Keywords

  • Ablation
  • Electroanatomical mapping
  • Premature ventricular contraction
  • Transvenous ablation
  • VIVO™ device
  • Ventricular ablation
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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