Real-world assessment of Multipolar and Point-by-Point Mapping for Premature Ventricular Contraction Ablation.

We aimed to assess acute and midterm efficacy of premature ventricular contraction (PVC) ablation guided by multielectrode and point-by-point (PbP) mapping. Retrospective, international multicenter study of consecutive patients referred for PVC ablation in 10 hospital centers from January 2017 to December 2021. Based on the mapping approach two cohorts were identified: the "Multipolar group" where a dedicated high density mapping catheter was employed and the "PbP group" where mapping was performed with the ablation catheter. Procedural endpoints, safety, acute (procedural) and midterm efficacy were assessed. Of the 698 patients included in this study, 592 received activation mapping (46% males, median age of 55[41-65] years) - 248 patients in the Multipolar group and 344 patients in the PbP group. A higher number of activation points (432 [217-843] vs. 95 [42-185], p<0.001), reduced mapping time (40±38 min vs. 61±50 min, p<0.001), and shorter procedure time (124±60 min vs. 143±63 min, p<0.001) were reported in the Multipolar group. Both groups had high acute success rates (84.7% with Multipolar mapping vs. 81.3% with PbP mapping, p=0.63), as well as midterm efficacy (83.4% vs. 77.4%, p=0.08), with no significant differences in the risk of adverse events (6.0% vs. 3.5%, p=0.24). However, for left-sided PVC ablation specifically, there was higher midterm efficacy in the Multipolar group (80.7% vs. 69.5%, p=0.04), with multipolar mapping being an independent predictor of success (adjusted OR= 2.231 [95% CI, 1.476-5.108], p=0.02). Acute and midterm efficacy of PVC ablation is high with both multipolar and PbP mapping, although the former allow for quicker procedures and may potentially improve the outcomes of left-sided PVC ablation.

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© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.