Prof Sabine Ernst, an electrophysiologist at Royal Brompton Hospital, London, UK, and a longtime investigator with the VIVO system, discusses her use of non-invasive 3D mapping to guide PVC ablations. She highlights the advantage of performing mapping on the ward – while patients are ambulatory and more likely to exhibit arrhythmias – which saves time and captures critical data before entering the lab. Prof Ernst notes that VIVO is particularly effective for identifying single-source PVCs, rare ectopics and arrhythmias from challenging locations like the epicardium, supporting better procedural planning and patient communication. She concludes that VIVO enables clearer risk discussions and helps manage expectations, ultimately leading to more efficient and targeted ablations.

Dr Leonor Parreira, an electrophysiologist in Lisbon, Portugal, outlines the advantages and future potential of the VIVO non-invasive mapping system for ventricular ablation. Primarily used pre-procedurally, VIVO helps Dr Parreira identify arrhythmia origins, enabling faster, more precise procedures and sometimes avoiding unnecessary ones – especially in patients with low PVC burden or unstable arrhythmias. It’s also effective in complex cases with multiple morphologies or brief episodes of ventricular tachycardia. Dr Parreira envisions a shift toward fully non-invasive treatments, with VIVO playing a key role in both current workflows and emerging approaches like stereotactic radiotherapy and substrate-based ablation.

Dr Gabor Szeplaki, an electrophysiology at Mather Private Hospital in Dublin, Ireland, discusses the value of the non-invasive VIVO mapping system for pre-procedural premature ventricular contraction (PVC) mapping. By combining ECG data with a CT scan, the system helps Dr Szeplaki accurately localise the PVC source, which is particularly useful when PVCs are infrequent or hard to detect during the procedure itself. This pre-procedural insight improves efficiency, safety, and outcomes, especially in challenging cases. Dr Szeplaki highlights the benefit of integrating this data with 3D mapping and intracardiac echo during the procedure, and notes that early detection of complex or risky PVC sites may even inform the decision to postpone or avoid invasive treatment.