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Abstract：
OBJECTIVE: We aimed to assess the acute and midterm efficacy of premature ventricular contraction (PVC) ablation guided by multielectrode and point-by-point (PbP) mapping.
RESULTS: This is a retrospective, international multicentre study of consecutive patients referred for PVC ablation in 10 hospital centres 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, and acute (procedural) and midterm efficacies 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 vs. 61 ± 50 min, P < 0.001), and shorter procedure time (124 ± 60 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 a 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].
CONCLUSIONS: The acute and midterm efficacies of PVC ablation are high with both multipolar and PbP mapping, although the former allows for quicker procedures and may potentially improve the outcomes of left-sided PVC ablation.
RESULTS: This is a retrospective, international multicentre study of consecutive patients referred for PVC ablation in 10 hospital centres 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, and acute (procedural) and midterm efficacies 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 vs. 61 ± 50 min, P < 0.001), and shorter procedure time (124 ± 60 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 a 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].
CONCLUSIONS: The acute and midterm efficacies of PVC ablation are high with both multipolar and PbP mapping, although the former allows for quicker procedures and may potentially improve the outcomes of left-sided PVC ablation.
摘要：
目的：我们旨在通过多电极和逐点（PbP）标测来评估室性早搏（PVC）消融的急性和中期疗效。
方法：回顾性，2017年1月至2021年12月在10个医院中心连续转诊接受PVC消融的患者的国际多中心研究.根据标测方法确定了两个队列：使用专用高密度标测导管的“多极组”和使用消融导管进行标测的“PbP组”。程序端点,安全,评估急性(手术)和中期疗效.
结果：本研究纳入的698名患者中，592人接受了激活映射(46%的男性，中位年龄55[41-65]岁)-多极组248例患者和PbP组344例患者。更多的激活点（432[217-843]与95[42-185],p<0.001)，减少作图时间(40±38分钟与61±50分钟,p<0.001)，和更短的手术时间(124±60分钟与143±63分钟，p<0.001)在多极组中报告。两组的急性成功率均较高（多极标测组的成功率为84.7％，与用PbP作图81.3%，p=0.63),以及中期疗效(83.4%vs.77.4%,p=0.08),不良事件风险无显著差异(6.0%vs.3.5%,p=0.24）。然而,特别是对于左侧PVC消融，多极组的中期疗效更高(80.7%vs.69.5%,p=0.04),多极映射是成功的独立预测因子(调整后的OR=2.231[95%CI，1.476-5.108]，p=0.02)。
结论：在多极和PbP标测下，PVC消融的急性和中期疗效都很高，尽管前者允许更快的手术，并且可能会改善左侧PVC消融的结果。
方法：回顾性，2017年1月至2021年12月在10个医院中心连续转诊接受PVC消融的患者的国际多中心研究.根据标测方法确定了两个队列：使用专用高密度标测导管的“多极组”和使用消融导管进行标测的“PbP组”。程序端点,安全,评估急性(手术)和中期疗效.
结果：本研究纳入的698名患者中，592人接受了激活映射(46%的男性，中位年龄55[41-65]岁)-多极组248例患者和PbP组344例患者。更多的激活点（432[217-843]与95[42-185],p<0.001)，减少作图时间(40±38分钟与61±50分钟,p<0.001)，和更短的手术时间(124±60分钟与143±63分钟，p<0.001)在多极组中报告。两组的急性成功率均较高（多极标测组的成功率为84.7％，与用PbP作图81.3%，p=0.63),以及中期疗效(83.4%vs.77.4%,p=0.08),不良事件风险无显著差异(6.0%vs.3.5%,p=0.24）。然而,特别是对于左侧PVC消融，多极组的中期疗效更高(80.7%vs.69.5%,p=0.04),多极映射是成功的独立预测因子(调整后的OR=2.231[95%CI，1.476-5.108]，p=0.02)。
结论：在多极和PbP标测下，PVC消融的急性和中期疗效都很高，尽管前者允许更快的手术，并且可能会改善左侧PVC消融的结果。
