November 12, 2020Pacing and Clinical Electrophysiology
Effectiveness of a 3D mapping benchmark for ablation in patients with atrioventricular nodal reentrant tachycardia
Key result
3D mapping for AVNRT ablation is linked to ~43% fewer ablations near the successful site.
- P<.01
- n=141
Why the study?
Avoiding excessively fast junctional rhythm during slow pathway modification for AVNRT helps prevent serious atrioventricular block, prompting evaluation of a predictive ablation point using 3D electroanatomical mapping.
Does using a predictive 3D mapping benchmark location marker improve procedural efficiency and safety during slow pathway ablation in patients with AVNRT?
Population
141 consecutive patients with common AVNRT receiving anatomical ablation to an antegrade slow pathway
Comparison
Ablation using a 3D predictive location marker vs ablation without it
Design
Single-center comparative cohort study
Authors
Discussion
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Member takes
Implication
May improve safety margins in AVNRT ablation; leaves open need for randomized confirmation.
Study Design
Type
Cohort (n=141)
Multicenter
No
Structured PICO
Does using a predictive 3D mapping benchmark location marker improve procedural efficiency and safety during slow pathway ablation in patients with AVNRT?
P
Population
141 consecutive patients with common atrioventricular nodal reentrant tachycardia (AVNRT) who received anatomical ablation to an antegrade slow pathway at a single institution between August 2013 and December 2019. Mean age 61.9 ± 16.9 years, 41.1% male.
I
Intervention
Ablation using a location marker that predicts successful ablation sites in a 3D mapping system (Group A)
C
Comparator
Ablation prior to the development of the location marker and therefore without it (Group B)
O
Outcome
Procedural metrics including frequency of excessively fast junctional rhythms, distance from His bundle to successful ablation point, number of ablations near the successful point, and number of accelerated junctional rhythmssurrogate
Main Result
Absolute Event Rate: 6.5% vs 11.4%
p-value: p=< .01
Using a predictive 3D mapping benchmark for slow pathway ablation in AVNRT reduces the number of required ablations and increases the distance from the His bundle, potentially improving procedural safety and efficiency.
Cite This Study
Yamamoto et al. (2020) conducted a cohort in Atrioventricular nodal reentrant tachycardia (AVNRT) (n=141). 3D mapping benchmark (location marker predicting successful ablation sites) vs. Conventional treatment without the location marker was evaluated on Number of ablations near the successful ablation point (p=< .01). Using a 3D mapping benchmark for AVNRT ablation significantly reduced the number of ablations near the successful ablation point compared to conventional treatment (6.5 vs 11.4, P<0.01).