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June 27, 2026EP EuropaceOpen Access

Anatomical ablation for basal PVCs is linked to ~29% lower acute success versus LAT-guided ablation.

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Why the study?

Does an anatomical approach compared to a local-activation-time guided approach improve acute success and reduce long-term recurrence in patients undergoing ablation for PVCs originating from the cardiac base?

Population

48 patients with symptomatic, high-burden premature ventricular complexes originating from the…

Comparison

Anatomical approach (AA) for catheter ablation vs Local-activation-time-guided catheter ablation

Design

Cohort

Follow-up

median 107 days (IQR 65–343 days)

Key result

Anatomical ablation for PVCs from the cardiac base had lower acute success (71% vs 100%, p=0.019) and higher long-term recurrence (54% vs 32%, p=0.21) compared to LAT-guided ablation.

Authors

NTN TsianakasPBP BengelPHP Huisl

Discussion

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Overview

LAT-guided ablation may improve acute success for basal PVCs; hypothesis-generating and requires randomized trials before practice change.

Key Points

  • The aim is to compare the effectiveness of LAT-guided versus anatomical approaches for ablation of PVCs originating from the cardiac base.
  • Retrospective, single-centre study
  • Included 48 patients with symptomatic PVCs from various cardiac sites
  • Measured PVC burden before and after intervention
  • Acute success rate was 100% for LAT group vs. 71% for anatomical group (p=0.019)
  • PVC burden significantly reduced from 20.4% to 5.7% overall (p=0.0001)
  • Long-term recurrence was 32% in LAT group compared to 54% in anatomical group (p=0.21)

Study Design

Type

Cohort (n=48)

Multicenter

No

Structured PICO

Does an anatomical approach compared to a local-activation-time guided approach improve acute success and reduce long-term recurrence in patients undergoing ablation for PVCs originating from the cardiac base?

P
Population
48 patients with symptomatic, high-burden PVCs originating from the cardiac base, followed for a median of 107 days.
E
Exposure
Anatomical approach (AA) for catheter ablation
C
Comparator
Local-activation-time (LAT)-guided catheter ablation
O
Outcome
Acute successsurrogate

Main Result

Absolute Event Rate: 71% vs 100%

p-value: p=0.019

Anatomical ablation for basal PVCs is feasible and reduces PVC burden, but is associated with lower acute success and potentially worse long-term outcomes compared to LAT-guided ablation.

Cite This Study

Tsianakas et al. (2026) conducted a cohort in Symptomatic, high-burden premature ventricular complexes (PVCs) (n=48). Anatomical approach (AA) for catheter ablation vs. Local-activation-time (LAT)-guided ablation was evaluated on Acute success (p=0.019). Anatomical ablation for PVCs from the cardiac base had lower acute success (71% vs 100%, p=0.019) and higher long-term recurrence (54% vs 32%, p=0.21) compared to LAT-guided ablation.

synapsesocial.com/papers/6a3f97a5125782b61d8658achttps://doi.org/10.1093/europace/euag105.1113
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Efficacy and safety of a sandwich ablation strategy for idiopathic PVCs: insights from a propensity-matched cohort2026
  2. 2Site-dependent outcomes in Premature Ventricular Contraction (PVC) ablation: insights from a cohort study2026
  3. 3Ablation outcomes in PVC-induced cardiomyopathy: A systematic review and meta-analysis stratified by site of origin2026
  4. 4Entirely anatomical high-power ablation for refractory left ventricular summit arrhythmias2026
  5. 5Catheter ablation of premature ventricular complexes originating from papillary muscles using dual-energy lattice-tip focal catheter2026