Mapping and radiofrequency ablation in the sinus of Valsalva under intracardiac echocardiography guidance without routine coronary angiography achieved acute and effective ablation in 81.4% of patients with no adverse events.
Observational (n=70)
No
Does mapping and radiofrequency ablation guided by intracardiac echocardiography without routine coronary angiography safely and effectively treat arrhythmias in the sinus of Valsalva?
Mapping and radiofrequency ablation in the sinus of Valsalva can be safely performed using intracardiac echocardiography guidance without routine coronary angiography by experienced operators.
BACKGROUND: Radiofrequency ablation at the region of the sinus of Valsalva carries a risk to the ostia of the coronary arteries. Coronary angiography is usually utilized to document a safe distance for mapping and ablation. OBJECTIVE: To show that catheter ablation in the aortic root could be guided by phased-array intra cardiac echocardiography (ICE) and electro anatomic mapping without the need for coronary angiography. METHODS: We reviewed all patients referred to our lab that underwent mapping and/or ablation in the sinus of Valsalva region. Procedures were carried out by operators that are skilled in the use of ICE. The need for angiography was documented, also the rate of success along with the immediate and 30-day complications rate. RESULTS: Seventy patients (average age 48.7 ± 13.8 years; 64.3% males) were referred for ablation of ventricular and atrial arrhythmias. PVC constituted 95.7% of the cases. All patients underwent mapping and/or ablation at the sinus of Valsalva region without the need for coronary angiography to visualize the coronary ostia. Acute and effective ablation was achieved in 57 out of 70 (81.4%) patients partially effective ablation was achieved in 10 (14.3%) patients, and failure to ablate in the remaining 3 patients (4.3%). There was no occurrence of any adverse events, neither immediately or at day 30 after the procedure. CONCLUSION: In the hands of experienced operators, mapping and radiofrequency ablation in the sinus of Valsalva can be safely and reliably performed using intracardiac echocardiography alone without the need for supplementary catheter coronary angiography.
Asmar et al. (Tue,) conducted a observational in Ventricular and atrial arrhythmias in the sinus of Valsalva region (n=70). Mapping and radiofrequency ablation under intracardiac echocardiography (ICE) guidance was evaluated on Acute and effective ablation. Mapping and radiofrequency ablation in the sinus of Valsalva under intracardiac echocardiography guidance without routine coronary angiography achieved acute and effective ablation in 81.4% of patients with no adverse events.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: