Propagation mapping revealed a wave collision within the triangle of Koch, with the successful ablation site located on or superior to the wave collision in 87% of patients and within 4.0 mm in 69%.
Observational (n=39)
Yes
Does the site of wave collision on propagation mapping correlate with the successful site of ablation in pediatric and young adult patients with AVNRT?
Propagation mapping identifying a wave collision within the triangle of Koch correlates closely with the successful site of ablation for AVNRT, suggesting it may improve slow-pathway localization.
Voltage mapping has been used previously for slow-pathway localization for atrioventricular nodal reentrant tachycardia (AVNRT) ablation. However, propagation mapping may be a technique to further improve the localization of the slow pathway. This retrospective study aimed to evaluate the relationship of the propagation map to both the voltage mapping and successful site of ablation in patients who underwent ablation for AVNRT. All patients ≤20 years of age who underwent voltage mapping for AVNRT were included in this study. Patients were excluded if they had congenital heart disease or inadequate voltage point density within the triangle of Koch (TK). During the study, a propagation map was evaluated from the prior voltage map, marking a "wave collision" at the site of atrial wave convergence. Patient and procedural information, the location of the wave collision, the site of successful ablation, and the appearance of the voltage map were evaluated. Ultimately, 39 patients aged from four years of age to 20 years of age were evaluated. Success was achieved in 100% of patients, with a recurrence rate of 2.8% and no long-term complications observed. The average procedure time was 127 min. Follow-up length averaged seven months post operation. Low-voltage areas, and a wave collision, were present in all patients. This wave collision was typically located within the TK. The median number of ablations required for successful outcome was two. The successful ablation lesion was typically located over a low-voltage area within 4 mm of the wave collision within the TK. In conclusion, we found in this retrospective evaluation that propagation mapping resulted in a wave collision within the TK, and that the successful ablation site in the majority of patients was near a low-voltage area within 4 mm, typically superiorly, to the wave collision within the TK.
Aartsen et al. (Fri,) conducted a observational in Atrioventricular Nodal Reentry Tachycardia (AVNRT) (n=39). Propagation mapping combined with voltage mapping was evaluated on Successful ablation site located on or superior to the wave collision. Propagation mapping revealed a wave collision within the triangle of Koch, with the successful ablation site located on or superior to the wave collision in 87% of patients and within 4.0 mm in 69%.