Myocarditis is an important and frequently underrecognized cause of atrioventricular conduction disease and ventricular arrhythmias and may also be associated with atrial arrhythmias and sinus node dysfunction. Arrhythmic risk evolves over time as a result of the interplay between myocardial inflammation, fibrosis, and genetic predisposition. Despite its clinical relevance, guidance for the diagnosis, treatment, and follow-up of arrhythmias in myocarditis has remained limited. This consensus statement provides a structured framework for the management of arrhythmias in myocarditis and inflammatory cardiomyopathy (Infl-CMP), integrating disease phase and genetic background into clinical decision-making. It offers practical guidance across the disease spectrum, including diagnostic evaluation, therapeutic strategies, and longitudinal follow-up. The document was jointly developed by the European Heart Rhythm Association of the European Society of Cardiology (ESC) in collaboration with the Heart Failure Association of the ESC, the ESC Working Group on Myocardial & Pericardial Diseases, and the European Association of Preventive Cardiology of the ESC, together with the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society. Consensus advice is organized using a phase-aware framework distinguishing hot, hot-to-cold, and cold phases, with clinical consensus statements graded according to opinion-, observational-, or randomized trial-based evidence and supported by formal author voting. Arrhythmia management is stratified by disease phase. During active inflammation, antiarrhythmic therapy is combined with aetiology-targeted treatment or immunosuppression when indicated. In later stages, substrate-based strategies include pharmacological therapy, device implantation, or ablation. Emphasis is placed on hot-to-cold transition as an arrhythmogenic window and on risk stratification.

Anhaltende ventrikuläre Tachykardien (VT) sind potenziell lebensbedrohliche Herzrhythmusstörungen mit hoher klinischer und prognostischer Relevanz. Sie treten sowohl idiopathisch bei strukturell normalem Herzen als auch im Rahmen ischämischer und nichtischämischer Kardiomyopathien auf. Implantierbare Kardioverter-Defibrillatoren (ICD) senken zwar das Risiko des plötzlichen Herztodes, verhindern jedoch weder rezidivierende VTs noch deren negative Auswirkungen auf Lebensqualität und Krankheitsprogression. Die Katheterablation hat sich durch Fortschritte in Bildgebung, Mappingtechniken und Ablationsverfahren zu einer etablierten Therapieoption entwickelt und ist heute fest in den Leitlinien verankert. Dieser Übersichtsartikel stellt die pathophysiologischen Grundlagen ventrikulärer Arrhythmien dar und ordnet die VT-Ablation in den klinischen Gesamtzusammenhang ein. Diskutiert werden Indikationen, Wirksamkeit und Risiken der VT-Ablation sowie der optimale Zeitpunkt des Eingriffs. Randomisierte Studien zeigen konsistent eine Reduktion von VT-Rezidiven, ICD-Schocks und Hospitalisationen bei akzeptabler Komplikationsrate, während ein gesicherter Einfluss auf die Gesamtmortalität bislang fehlt. Abschließend werden zukünftige Entwicklungen wie die Integration hochauflösender Bildgebung, alternative und nichtinvasive Ablationsverfahren sowie neurokardiale und molekulare Therapiekonzepte dargestellt, die den Weg zu einer zunehmend personalisierten Behandlung ventrikulärer Tachykardien ebnen.

BACKGROUND AND AIMS:Stereotactic arrhythmia radioablation (STAR) is increasingly used for refractory ventricular tachycardia (VT), yet prospective multicentre outcome data remain limited. Here, the planned interim analysis of the prospective Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary (STOPSTORM) registry is reported. METHODS:STOPSTORM is a European prospective, international, multicentre registry of patients treated with STAR. The primary efficacy endpoint was the change in sustained VT episode burden comparing the 6 months before versus the 6 months after STAR. The primary safety endpoint was the occurrence of serious adverse events (SAEs) adjudicated as possibly or probably treatment-related. Overall survival was assessed using time-to-event methods. RESULTS:Across 28 centres, 193 patients were included (mean age 68±9 years; 88% male; 53% non-ischaemic cardiomyopathy). Median follow-up was 19 months. Among 107 evaluable patients with ≥6-month follow-up, the median VT episode burden was reduced by 80% after STAR. Among patients surviving ≥6 months, 72% were free from implantable cardioverter-defibrillator (ICD) shock. In the full cohort, 12 SAEs were adjudicated as possibly or probably treatment-related, including pericardial effusion, coronary events, and early post-treatment ventricular arrhythmia. Overall survival probability was 77% at 12 months. CONCLUSIONS:In the largest prospective multicentre cohort reported to date, STAR was associated with a substantial reduction in VT burden and ICD shocks, with a low frequency of possibly or probably treatment-related SAEs.

Trotz der aktuellen technischen Fortschritte bei der Implantation aktiver Rhythmusimplantate („cardiovascular implantable electronic devices“, CIED) treten perioperative Komplikationen auf. In der Literatur werden relevante Komplikationsraten von etwa 2–11

Despite major advances in cardiovascular implantable electronic devices (CIEDs) and implantation techniques, perioperative complications remain clinically relevant. Reported rates of relevant complications after transvenous CIED implantation range from 2 to 11% and may adversely affect patient outcomes. Major complications include access-related vascular injuries, venous thrombosis, pneumothorax and hemothorax, and cardiac complications such as lead perforation or tricuspid valve dysfunction, lead dislodgement, unrecognized malposition of the right ventricular lead in the left ventricle, arrhythmias, pocket hematoma, and device-related infections. This article provides a structured overview of the most relevant perioperative complications associated with CIED implantation. Practical strategies for prevention, early detection, and appropriate management of these complications are also discussed. Given the increasing number of procedures, the growing complexity of device systems, and the rising proportion of multimorbid patients, meticulous procedural planning and strict adherence to preventive measures are essential to improve safety and clinical outcomes.

Background: Hypokalemia is a potentially reversible cause of ventricular tachyarrhythmias (VTAs) such as polymorphic ventricular tachycardia/ventricular fibrillation (PMVT/VF) and sustained monomorphic ventricular tachycardia (SMVT). Despite its established role in arrhythmogenesis, the clinical implications of hypokalemia in patients with distinct VTA subtypes remain poorly understood. Objective: The aims of this study were to study the clinical characteristics, management, and outcome of patients with hypokalemia-associated VTAs and to investigate the prognosis of distinct VTA subtypes after correction of hypokalemia with or without additional VT–targeted therapies (VTTTs), such as catheter ablation or antiarrhythmic drugs. Methods: Consecutive patients admitted with hypokalemia-associated VTAs were analyzed after hypokalemia correction. Patients were categorized by VTA subtype and followed for VT recurrence, 24-month VT-free survival, and all-cause mortality. Those with other reversible causes of VTAs were excluded. Results: Sixty-five patients (mean age 69 ± 12 years; 20% (n = 13) women; mean left ventricular ejection fraction 32% ± 13%; 54% (n = 35) with New York Heart Association class III/IV; 8% (n = 5) with a left ventricular assist device) were studied; 68% (n = 44) presented with SMVT. Patients with SMVT were younger (65 ± 11 years vs 77 ± 10 years; P < .001) and had more advanced left ventricular dilation (left ventricular end-diastolic diameter 64 ± 12 mm vs 57 ± 12 mm; P = .03). Over a median follow-up of 18 months, 24-month VT-free survival was 28%. Patients with SMVT had higher VT recurrence (50% vs 10%; P = .002) and lower 24-month VT-free survival (16% vs 52%; P = .005) than did those with PMVT/VF. Among patients with SMVT, those receiving VTTTs (36%, (n = 16/44)) showed improved 24-month VT-free survival compared with hypokalemia correction alone (31% vs 7%; P = .02). Conclusion: Hypokalemia-associated VTAs are associated with advanced heart failure and linked to poor outcomes, especially in patients with SMVT. Although potassium correction may be sufficient for patients with hypokalemia-associated PMVT/VF, those with SMVT require additional VTTTs to improve outcomes.

Background: Patients with nonischemic cardiomyopathies (NICMs) are at a risk for end-stage heart failure and death from ventricular arrhythmias. Implanted defibrillators (ICDs) protect against sudden arrhythmic death, but several studies suggest that ventricular arrhythmias are associated with worse outcomes despite ICDs. Objectives: This study evaluated the relationship of ventricular tachycardia (VT) with total mortality and nonsudden cardiovascular death (NSCVD) in NICM patients with ICDs enrolled in 2 multicentre trials. Methods: Patient-level data were analyzed from 2 prospective trials: DANISH (Danish Trial to Assess the Efficacy of ICDs in Patients with Nonischemic Systolic Heart Failure on Mortality) (ICD for primary prevention of sudden death) and dilated cardiomyopathy-VT (VT ablation). Primary endpoints were all-cause mortality or heart transplantation, and the secondary endpoint was NSCVD. Analyses included the entire group with multivariable analysis, a propensity-matched subgroup with and without VT at entry, VT patients with recent-onset VT in dilated cardiomyopathy-VT, and DANISH patients experiencing VT after primary prevention ICD. Results: Among 828 patients (median age 64 years, 23.3% females, median left-ventricular ejection fraction of 36%), 148 deaths occurred during a median follow-up of 3.9 years, with 78 (53%) due to NSCVD. Despite younger age and better left-ventricular ejection fraction, VT was independently associated with a >4-fold increase in mortality or transplantation (adjusted HR: 4.27 [95% CI: 2.60-7.03]) and a 7-fold increase in NSCVD (adjusted HR: 7.28 [95% CI: 3.80-13.97]). The findings were consistent across all subgroups. Conclusions: Patients with NICM experiencing VT are at an increased risk for mortality and NSCVD, suggesting that VT can be a marker for a more severe cardiomyopathy with important clinical implications.

Pulsed-field ablation (PFA) of atrial fibrillation (AF) has recently emerged as standard technique to achieve pulmonary vein isolation (PVI). Though complication rates have been reported to be lower with PFA compared to thermal ablation, further attempts should be made to minimize procedure-related complications. We aimed to assess vascular complications of PFA-based PVI using a streamlined procedural workflow including ultrasound-guided vascular access and access closure by subcutaneous Z-suture only. Consecutive patients who were scheduled for first-time catheter ablation of paroxysmal or persistent AF between December 2023 and September 2024 underwent PFA-based PVI following a streamlined procedural workflow. All procedures were performed after ≥4 weeks of uninterrupted oral anticoagulation in deep sedation and fluoroscopy-guided without use of electroanatomical mapping. No magnetic resonance or computed tomography imaging of the PVs nor transesophageal echocardiography was routinely performed. All patients underwent ultrasound-guided vascular access for a short 7F and long 13F stearable sheath (16.8F outer diameter), and access closure using a single subcutaneous Z-suture only without pressure bandage. Peri- and postoperative complications were assessed and patients followed for a minimum of 30 days for the purpose of the study. A total of 216 consecutive patients (67±11 years; 44% female; 54% persistent AF) were included for analysis. The overall rate of severe complications requiring intervention was 0.5% (1/216). No patient experienced a non-vascular complication related to device-specific PFA-based PVI (Table). Major vascular complications occurred in 2 patients (0.9%), of which one required intervention: 1 transient inferior ST-segment elevation due to coronary air embolism, and 1 accidental puncture of the inferior epigastric artery requiring coiling. Minor vascular complications occurred in 29.6% (64/216) of patients including acute bleeding after Z-suture closure requiring additional pressure bandage in 15.3% (33/216) and postinterventional major superficial hematoma in 5.6% (12/216). The average time from intervention to hospital discharge was 1.04±0.22 days with no difference between patients with and without vascular complication (1.05±0.21 vs. 1.04±0.23 days; p=0.83). Our proposed streamlined procedural workflow for PFA-based-PVI is highly effective and safe with an associated low rate (0.5%) of severe complications requiring intervention. However, minor bleeding complications frequently occurred with application of a single subcutaneous Z-suture only. Routine use of a pressure bandage should be reconsidered.Table

Atrial fibrillation ablation is an established procedure for the treatment of atrial fibrillation, in which Pulsed Field Ablation (PFA) is a novel method alongside radiofrequency and cryoablation. The article explains the technical basics of PFA, describes different types of catheters and gives detailed instructions on how to perform the procedure, from patient selection to sedation strategies and imaging. Important safety aspects and possible complications are also covered. Finally, the further development of PFA technology for the treatment of other arrhythmias and integration into 3D mapping systems is discussed. This work is part of a series of articles on further training in special rhythmology.

Leadless pacemakers (LP) have emerged as a validated alternative to conventional transvenous systems, offering significant complication reduction by eliminating leads and device pockets. Current LP technologies include the Micra™ series (Medtronic, Minneapolis, MN, USA) and the modular Aveir™ system (Abbott Laboratories, Abbott Park, IL, USA), enabling the first fully leadless dual-chamber pacing. Clinical benefits are most evident in patients at high infection risk or with venous access limitations. Advances such as atrioventricular (AV)-synchronous pacing and long battery life have broadened indications, while maintaining stable device performance. Key challenges remain in end-of-life management and guideline integration. Future directions may involve combinations with subcutaneous implantable cardioverter-defibrillators (ICDs) or energy-harvesting technologies, further expanding therapeutic applications.

Stereotactic arrhythmia radioablation (STAR) is a novel, non-invasive, and promising treatment option for ventricular arrhythmias (VAs). It has been applied in highly selected patients mainly as bailout procedure, when (multiple) catheter ablations, together with anti-arrhythmic drugs, were unable to control the VAs. Despite the increasing clinical use, there is still limited knowledge of the acute and long-term response of normal and diseased myocardium to STAR. Acute toxicity appeared to be reasonably low, but potential late adverse effects may be underreported. Among published studies, the provided methodological information is often limited, and patient selection, target volume definition, methods for determination and transfer of target volume, and techniques for treatment planning and execution differ across studies, hampering the pooling of data and comparison across studies. In addition, STAR requires close and new collaboration between clinical electrophysiologists and radiation oncologists, which is facilitated by shared knowledge in each collaborator's area of expertise and a common language. This clinical consensus statement provides uniform definition of cardiac target volumes. It aims to provide advice in patient selection for STAR including aetiology-specific aspects and advice in optimal cardiac target volume identification based on available evidence. Safety concerns and the advice for acute and long-term monitoring including the importance of standardized reporting and follow-up are covered by this document. Areas of uncertainty are listed, which require high-quality, reliable pre-clinical and clinical evidence before the expansion of STAR beyond clinical scenarios in which proven therapies are ineffective or unavailable.

BACKGROUND:Truncating titin variants (TTNtvs) are the most prevalent cause of inherited dilated cardiomyopathy. Occurrence of different ventricular arrhythmia (VA) subtypes, including premature ventricular complexes (PVCs), nonsustained ventricular tachycardia (NSVT), and sustained monomorphic VT (SMVT), has been reported. OBJECTIVES:The aim of this study was to analyze the prognostic relevance of distinct VA subtypes among TTNtv carriers and their underlying arrhythmogenic substrates. METHODS:Twenty-two TTNtv carriers referred for ablation of SMVT (n = 14) or frequent PVCs (n = 8) from 5 centers were included (mean age 56 ± 11 years; left ventricular ejection fraction 38% ± 13%; 77% male). Detailed phenotyping was performed, including Holter monitoring, cardiac imaging, and electroanatomical mapping. Patients were followed up for a median of 44 months. RESULTS:Demographic characteristics, including age, comorbidities, and left ventricular ejection fraction, were similar. NSVTs were frequent in both groups but faster in patients with SMVT (cycle length: 350 milliseconds [Q1-Q3: 315-403 milliseconds] vs 427 milliseconds [Q1-Q3: 395-469 milliseconds]). Although substrates for SMVT extended in a basal ring-like fashion with septal predominance, PVC sites of origin were limited to the basal anterior left ventricular segment. In the SMVT group, acute complete procedural success was achieved for 36%; during follow-up, 86% had recurrent VT, and 50% died of progressive heart failure. In the PVC group, complete abolition of PVCs was achieved in only 13%; at 3 months, median PVC burden was 1%, and there were no deaths or sustained VT during follow-up. VA subtype and NSVT cycle length were associated with mortality and poor VT-free survival. CONCLUSIONS:In TTNtv carriers, SMVTs but not frequent PVCs are associated with high mortality due to heart failure. Occurrence of SMVT may identify a subgroup at risk for rapid, progressive adverse remodeling. The prognostic significance of different VA subtypes needs to be confirmed in a larger cohort.

Catheter ablation of atrial fibrillation (AFCA) has emerged as standard treatment in patients (pts) with heart failure (HF) and left ventricular systolic dysfunction (LVSD). However, contribution of AF to LVSD (AF-mediated cardiomyopathy) varies significantly across the diverse HF population. Identifying patients who are most likely to benefit from AFCA and optimizing treatment strategies still remain a clinical challenge. To determine the impact of continuous ECG monitoring on the long-term outcomes of AFCA in pts with persistent AF and LVSD, and to assess independent predictors of echocardiographic response to AFCA. Consecutive pts with LVSD who underwent catheter ablation of persistent AF and concomitant implantable loop recorder insertion for continuous ECG monitoring between January 2016 and February 2022 were included for analysis if they met the following criteria: i) LVEF<50% in sinus rhythm at predischarge echocardiographic examination; and ii) echocardiographic follow-up (FU) of at least 12 months. Pts were followed for AF recurrence (>30s episode occurring after 90-day blanking period), AF burden and change in LVEF at 12 months. Response to AFCA was defined as an improvement of LVEF by ≥10% or recovery of LVEF during FU. A total of 160 pts (65±11 years; 21% female) were included and followed for a median of 36.2 (IQR 18.6-49.6) months. The mean baseline LVEF was 36±8%, 98% of pts had persistent AF, 17% of pts required repeated AFCA. At 12-month FU, LVEF improved to 46±10% (p<0.001), 102 pts (64%) responded to AFCA. Ninety pts (56%) presented with LVEF improvement ≥10%, 76 pts (48%) with LVEF normalization. The median absolute change in LVEF from baseline was overall +9.9% (IQR 1.8 to 17.0%), +15.9% (IQR 10.0 to 20.0%) in the responder vs. -1.1% (IQR -4.8 to 3.8%) in the non-responder group (p=0.027). The overall AF recurrence rate was 29.4% and the median AF burden 6.6% (IQR 3.7 to 9.5%) at 12-month post-AFCA. Compared to non-responders, responders had a significantly lower AF recurrence rate (23.5 vs. 39.7%; p=0.025) and AF burden (3.8 vs. 12.0%; p=0.030). They were significantly younger (63 vs. 68 years; p=0.005), had less frequent structural heart disease (37% vs. 64%; p=0.001) and a shorter history of HF (1.5 vs. 2.9 years; p=0.050). Absence of previous HF hospitalization (OR 0.652; 95% CI 0.411 - 0.923; p=0.014) and median AF burden (OR 0.971; 95% CI 0.960 – 0.994; p=0.021) predicted echocardiographic response to AFCA. Persistent AF frequently causes or contributes to LVSD. Rhythm control with AFCA results in significant improvement of LV systolic function, particularly in younger pts without underlying structural heart disease. Long-term continuous ECG monitoring is key to determine AF burden, which showed to be an independent predictor of echocardiographic response to AFCA in our study cohort.Definition of the study group Baseline characteristics

Die Vorhofflimmerablation ist ein etabliertes Verfahren zur Behandlung von Vorhofflimmern, bei dem die „pulsed field ablation“ (PFA) neben der Radiofrequenz- und Kryoablation eine neuartige Methode darstellt. Der Artikel erläutert die technischen Grundlagen der PFA, beschreibt verschiedene Kathetertypen und gibt detaillierte Anweisungen zur Durchführung der Prozedur, von der Patientenauswahl über Sedierungsstrategien bis hin zur Bildgebung. Wichtige Sicherheitsaspekte und mögliche Komplikationen werden ebenfalls behandelt. Abschließend werden die Weiterentwicklung der PFA-Technologie zur Behandlung weiterer Arrhythmien und die Integration in 3D-Mapping-Systeme thematisiert. Diese Arbeit ist Teil einer Artikelreihe zur Weiterbildung in der speziellen Rhythmologie.

Kabellose Herzschrittmacher (Leadless Pacemaker, LP) sind eine etablierte Alternative zu transvenösen Systemen und reduzieren durch den Verzicht auf Sonden und Aggregattasche das Komplikationsrisiko signifikant – in Studien um bis zu 63

Das „left bundle branch area pacing“ ist die aktuell verbreitetste Form der physiologischen Stimulation vor der His-Bündel-Stimulation. Sie soll die Entstehung einer schrittmacherinduzierten Kardiomyopathie verhindern bzw. beheben und kommt immer häufiger zum Einsatz. Um diese erfolgreich durchführen zu können, bedarf es neben einer Materialkunde v. a. der Kenntnis der spezifischen Anatomie und Röntgenanatomie sowie der EKG-Kriterien einer Linksschenkelstimulation. Dieser Artikel fast die technischen Voraussetzungen und Schritte einer erfolgreichen Implantation zusammen und zeigt Fallstricke auf.

Patients with chronic kidney disease face a high risk of sudden cardiac death, particularly in more advanced stages of renal dysfunction. Ventricular arrhythmias are prevalent and contribute to the heightened cardiovascular mortality. This review aims to explore the intricate interplay of disease-specific risk factors, arrhythmic triggers, and electrolyte disorders that amplify susceptibility to ventricular arrhythmias and sudden cardiac death in this population and influence the efficacy of available treatments.

Left bundle branch area pacing is currently the most common form of physiological pacing prior to His bundle pacing. It is intended to prevent or correct the development of pacemaker-induced cardiomyopathy and is being used more and more frequently. In order to be able to perform this successfully, knowledge regarding the specific anatomy and radiological anatomy as well as the ECG criteria for left bundle branch pacing is required in addition to knowledge of the tools. In this article, the technical requirements and steps for successful implantation are summarized and pitfalls are highlighted.

Abstract Background Activation mapping (AM) is the preferred approach to identify the premature ventricular complexes (PVC) site of origin (SOO) but it is limited when PVCs are infrequent. Pace-mapping (PM) is often used in combination with AM. Yet, relying on PM as sole guide for ablation requires a high accuracy for detecting the PVC SOO. Limited data exists on the accuracy of automated PM using PASO™ for identifying the SOO of idiopathic PVCs, particularly in the left ventricular outflow tract (LVOT). In two cohorts with both idiopathic and non-idiopathic PVCs, a PASO™ >94% was associated with ablation success. Purpose This study evaluated the accuracy of PM using the automated digital pace-matching module integrated in the CARTO mapping system for identifying the SOO of idiopathic outflow-tract PVCs. It also compared its accuracy in the LVOT versus the right ventricular outflow tract (RVOT). Methods Consecutive patients undergoing successful ablation of idiopathic outflow-tract PVCs were prospectively included. AM and PM were performed with a 3.5mm tip catheter. PM was conducted at 2mA, 5mA, or 10mA output, selecting the lowest output that captured at each site. Ablation was performed at the site of earliest bipolar local activation time. The PVC SOO was defined as the site of acute ablation success. The distance between the best PM (BPM) and the SOO and the areas defined by PM ≥98%, ≥96%, and ≥94% were measured. Long-term success was defined by a ≥80% reduction in PVC burden at 3-month follow-up. Results In total, 27 patients were included; 18 had PVCs from the RVOT and 9 from the LVOT. All procedures were acutely successful after a median of 2 (IQR 1-3) radiofrequency applications (RFA) in the RVOT and one (IQR 1-2) RFA in the LVOT. In the RVOT, the median BPM was 98.1% (98.0-98.6), the median distance from the BPM to the SOO was 3.5 mm (IQR 0–8.5mm) and the areas of PM ≥98%, ≥96%, ≥94% were 1.2cm2 (0.5 – 1.8), 3.4cm2 (1.5-4.7) and 7.1cm2 (4.9-11.1). In the LVOT, the median BPM was 95.5% (IQR 94.9 – 97.8%) and the median distance from the BPM to the SOO was 8 mm (IQR 2–15mm). Only 3/9 patients with LVOT PVCs had a BPM ≥96% (1/9 ≥98%) and in all 3, the PVC SOO was coincident with the BPM site. From the remaining 6 patients, 5 had a BPM ≥94% but only in 2/5 the PVC SOO was within the area defined by the BPM site. In 26/27 (96%) patients, no PVC recurrence was documented after 3 months (median burden 0% [IQR 0-0]). Conclusions The accuracy of using the best pace-match provided by PASO™ for identifying the PVC SOO in the RVOT is high, making it a suitable target for limited ablation when activation mapping is not possible because of insufficient PVCs. In the LVOT, the best pace-match is frequently lower than in the RVOT and it misses the PVC SOO in almost half of the patients. The previously suggested PM >94% cut-off seems to be insufficient to identify the PVC SOO in both the RVOT and LVOT.TablePacemap