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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1558130

The utility of 24-hour electrocardiogram recordings for prediction of a sufficient number of premature ventricular complexes and mapping strategy during catheter ablation

Provisionally accepted
Stine Aagaard-Nilsen Stine Aagaard-Nilsen 1Lars Andreas Dejgaard Lars Andreas Dejgaard 2Ole-Gunnar Anfinsen Ole-Gunnar Anfinsen 2Erik Lyseggen Erik Lyseggen 2Torbjørn Holm Torbjørn Holm 2Trine Synnøve Fink Trine Synnøve Fink 2Hans Henrik Odland Hans Henrik Odland 2Knut Sevre Knut Sevre 2Erik Kongsgaard Erik Kongsgaard 2Finn Hegbom Finn Hegbom 2Mathis Korseberg Stokke Mathis Korseberg Stokke 1*
  • 1 University of Oslo, Oslo, Norway
  • 2 Department of Cardiology, Oslo University Hospital, Oslo, Norway

The final, formatted version of the article will be published soon.

    Insufficient number of premature ventricular complexes (PVCs) during catheter ablation (CA) may prohibit adequate mapping of the site of origin. Parameters to predict this situation have not been established. Our objective was to quantify the association between preprocedural information and the probability of sufficient number of PVCs for adequate mapping and successful CA.Clinical characteristics and results from examinations and procedural data were collected retrospectively from health journals for patients admitted for CA of PVCs from 2011 to 2020.Forty-six of 332 patients (14%) had insufficient number of PVCs to enable adequate electroanatomical mapping. Patients with sufficient number of PVCs had nominally more PVCs in the 24-hour electrocardiogram (ECG), with a strong statistical trend (16007 (6509-26205) vs. 8332 (3066-20974), p=0.055). The receiver operator curve for sufficient number of PVCs in 24h ECGs had an area under the curve of 0.610 (95% CI 0.498-0.722, p=0.055). The best predictive values were found at >10000 PVCs per 24h, with a positive predictive value of 67% and negative predictive value of 57%. Patients for whom activation mapping was used as the sole mapping method had more PVCs in the 24h ECG than did patients for whom pace mapping was added or used as an alternative (19769 (10564-30526) vs. 15237 (6000-25033), p=0.022). Neither acute outcome nor procedure time depended on the mapping strategy.The number of PVCs in 24h ECGs was moderately associated with the presence of sufficient number of PVCs to perform electroanatomical mapping during CA. The presence of more PVCs in the preprocedural 24h ECG was associated with the use of activation mapping as the sole mapping strategy.

    Keywords: arrhythmia, Premature ventricular complexes, Ambulatory electrocardiography, Catheter Ablation, outcome prediction

    Received: 09 Jan 2025; Accepted: 10 Feb 2025.

    Copyright: © 2025 Aagaard-Nilsen, Dejgaard, Anfinsen, Lyseggen, Holm, Fink, Odland, Sevre, Kongsgaard, Hegbom and Stokke. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mathis Korseberg Stokke, University of Oslo, Oslo, Norway

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