EP Fellows Curriculum: Mapping and Ablation of Outflow PVCs/VTs-EP Fellows Curriculum: Mapping and Ablation of Outflow PVCs/VTs

Video Transcription

Video Summary

In this video, Dr. Jason Bradfield discusses the topic of outflow ventricular arrhythmias, including premature ventricular contractions (PVCs) and ventricular tachycardia (VT). He emphasizes the importance of comprehensive mapping and understanding the anatomy of the outflow tracts to ensure a successful ablation procedure.<br /><br />Dr. Bradfield starts by debunking the common belief that the right ventricular outflow tract (RVOT) is the most common source of these arrhythmias. He explains that while the RVOT is indeed a common site, it is not as prevalent as often reported. He also highlights the need to consider the possibility of structural heart disease in these patients, as a small percentage may have underlying heart issues that can drastically affect their management.<br /><br />He further explains the complexity of the anatomy and physiology of the outflow tracts, and how different sites of origin can lead to confusion in mapping and ablation procedures. He discusses the concept of preferential conduction and how it can impact the mapping of these arrhythmias. He also highlights the importance of considering the interaction between this complex anatomy and the possibility of preferential conduction.<br /><br />Dr. Bradfield discusses various techniques and approaches for mapping and ablation, including wire mapping, bipolar ablation, and surgical techniques like cryo-ablation. He concludes by emphasizing the iterative nature of planning and adjusting the approach based on evolving information during the procedure.<br /><br />In summary, Dr. Bradfield emphasizes the importance of understanding the anatomy and physiology of the outflow tracts in mapping and ablation procedures for outflow ventricular arrhythmias. He highlights the need for comprehensive mapping, the consideration of potential structural heart disease, and the importance of continuous planning and adjustment throughout the procedure.

Keywords

Dr. Jason Bradfield

outflow ventricular arrhythmias

premature ventricular contractions

ventricular tachycardia

comprehensive mapping

anatomy of outflow tracts

successful ablation procedure

right ventricular outflow tract

structural heart disease

complexity of anatomy and physiology