Ablation of premature ventricular complexes originating from the left ventricular outflow tract using a novel automated pace-mapping software

Pace-mapping is an important tool during the ablation of premature ventricular complexes (PVCs) or ventricular tachycardia. The automated pace mapping system software (PaSo module, CARTO XP v9, Biosense/Webster) allows direct comparisons between paced ECGs and the acquired PVC ECG during ablation in a reasonable time. We report our experience with the automated pace mapping system during the ablation of PVCs in the left ventricular outflow tract (LVOT). A 67-year-old male patient was referred to our Department because of recurrent resting atypical chest pain. A 12 lead ECG showed frequent PVCs with LVOT morphology and a 24-hour Holter ECG revealed, that 31% of the total beats were monomorphic PVCs. We decided to perform a radiofrequency catheter ablation. After recording an electroanatomic and an activation map during PVCs, pace-mapping was performed with the PaSo module of the CARTO system. The best percent match area (89.0%) was found in the LVOT, where we performed multiple ablations and PVCs disappeared. According to our initial experience, automated pace-mapping systems might be useful during ablation of PVCs or ventricular tachycardias. Appropriate use of the software allows more objective and faster comparisons compared with conventional manual techniques.