Iranian Heart Association Iranian Heart Journal 26 1 2025 01 01 Electrocardiographic and Demographic Characteristics of Premature Ventricular Contractions With Unsuccessful Ablation 27 34 212294 EN Mohammad Javad Aminizadeh Rajaie Cardiovascular Medical and Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. 0009-0006-7234-7961 Samira Esfandiari Mehni Rajaie Cardiovascular Medical and Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. 0009-0000-8911-7587 Ali Daryanavard Rajaie Cardiovascular Medical and Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Roya Rezai Rajaie Cardiovascular Medical and Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Ali Asghari Rajaie Cardiovascular Medical and Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Seyed Saeed Dadgar Rajaie Cardiovascular Medical and Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Sadaf Fani-Hanifeh Rajaie Cardiovascular Medical and Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran. Hooman Bakhshandeh Cardiovascular Epidemiology Research Center, Rajaie Cardiovascular Medical and Research Institute, Tehran, IR Iran. 0000-0002-5102-1501 Shabnam Madadi Cardiac Electrophysiology Research Center, Rajaie Cardiovascular, Medical, and Research Institute, Iran University of Medical Sciences, Tehran, IR Iran. 0000-0002-7543-8424 Journal Article 2024 04 28 Background: Premature ventricular contractions (PVCs) are the most common arrhythmia observed in ECGs. Analyzing PVC patterns in ECGs aids in identifying types with a higher likelihood of unsuccessful ablation. This study aimed to investigate the ECG and demographic characteristics of these PVCs. Methods: This study included all patients with PVCs who were hospitalized and underwent unsuccessful ablation at the Rajaie Cardiovascular Medical and Research Institute between 2017 and 2022. ECG results were compared, and PVC patterns in different types were identified. Results: The study comprised 80 patients, ranging from 17 to 79 years of age, with a male predominance of 63% and a female representation of 37%. The most frequently observed locations for PVCs were the left ventricular summit (n =27 [34%]), the right ventricular outflow tract (n =13 [9.3%]), papillary muscles (n = 7 [9%]), the great cardiac vein (n =6 [8%]), the mitral and tricuspid annulus (n = 5 [6%]), the aortomitral continuity (n =3 [4%]), the fascicle (n = 3 [4%]), and the mid-myocardial part (n = 3 [4%]). Almost all patients (96.3%) experienced symptoms, and the average ejection fraction was 39.2%. Regarding transition location, 50% occurred in lead V3 (the gray zone). Additionally, 32.5% of the patients demonstrated late transition, 3% showed early transition, and the remaining subjects exhibited positive concordance. Another parameter, breakthrough, was observed in 56% of patients. Conclusions: In this study, the left ventricular summit was identified as the most common site for unsuccessful PVC ablation. This finding highlights the importance of precise electroanatomic mapping during the ablation process. Furthermore, a notable pattern observed in cases of unsuccessful PVC ablation was the breakthrough pattern, suggesting that this pattern could serve as a potential predictor for the success of the ablation procedure. (Iranian Heart Journal 2025; 26(1): 27-34)

https://journal.iha.org.ir/article_212294_3f3fc4f6baceff19a6f830d687326e0f.pdf