CONGRESS ABSTRACT

Premature ventricular contraction (PVC) is the most typical form of idiopathic ventricular arrhythmias. Although known to be benign, high-burden PVC cause changes in myocardial structure and even severe heart failure. For this reason, catheter ablation (CA) is recommended.CA is performed at the earliest local activation time (LAT) positions.The novel OT Near Field algorithm that utilizes signal frequency to assess if a signal is ‘far-field’ or ‘near-field’ thanks to the analysis of the signals’ sharpness could better predict PVCs’ origin.The purpose of this study is to investigate its role in PVC mapping. We retrospectively investigated consecutive cases at Teramo Hospital.We performed retrospective review of archived electroanatomic maps  for each targeted PVC. Ablation was performed at the earliest LAT position and we investigated if earliest LAT position annotated with OTNF algorithm guided better than usual method.4 PVCs procedures met the including criteria.The 50% of the patients were men and 50% were women.The youngest patience was 32, while the oldest was 55 years old. 3 (75%) PVCs origin site were identified in the right part (RVOT) while 1 was from the left ventricle (LCC). Skin to skin procedural time was 90[78-120] min including 20 min waiting time. We retrospectively investigated 4 electroanatomic maps, one for each PVCs procedure.Median mapping time, using HD grid catheter was 20[13-31] minutes in which 2900[1040-4900] mapping points were acquired.Total procedural time spent for PVCs ablation was 20[15-30] min, in which 364[180-600] sec of RF current was delivered. In all cases the earliest point area targeted by OTNF algorithm was entirely covered by RF applications. In all cases the PVCs were suppressed. The suppression of the targeted PVCs was achieved for all procedures with an acute success of 100%.Present study provides best LAT targeted through omnipolar signal in the earliest area of PVCs.We suggest that both first deflection and the OTNF algorithm maps can guide PVC ablation, but the OTNF showed better guide the one-shot application.In fact, in all cases, as showed in Fig.1 the target area is smaller and well specified. The efficacy RF application in on the signal related to the best LAT founded using the OTNF algorithm instead of first deflection one, as showed in Fig.2. So, this new algorithm can provide a specific target reducing RF time and extension. Our result needs to be validated in a higher pool of prospectic PVCs ablation.