Key result
Zero-fluoroscopy 3D-guided PICENO AVNRT approach achieves 100% acute success without AV block.
Why the study?
Slow-pathway ablation for AVNRT carries a small risk of atrioventricular block, and a fully standardized, safety-driven 3D-guided workflow tailored to AVNRT ablation had not been clearly defined.
Does the standardized PICENO AVNRT approach (3D-guided zero-fluoroscopy workflow) provide safe and effective slow-pathway ablation in patients with AVNRT?
Observational (n=150)
Does the standardized PICENO AVNRT approach (3D-guided zero-fluoroscopy workflow) provide safe and effective slow-pathway ablation in patients with AVNRT?
A standardized 3D-guided, zero-fluoroscopy workflow for AVNRT ablation achieves 100% acute success and eliminates radiation exposure without causing AV block.
Answers are grounded in this paper and cite their sources.
May support radiation-free AVNRT ablation without AV block; leaves open randomized confirmation before practice change.
INTRODUCTION: Slow-pathway ablation for atrioventricular nodal re-entrant tachycardia (AVNRT) is highly effective but carries a small risk of atrioventricular block. A fully standardized, safety-driven 3D-guided workflow tailored to AVNRT ablation has not been clearly defined. METHODS AND RESULTS: We retrospectively analyzed 150 consecutive day-hospital patients with invasive electrophysiological confirmation of AVNRT who underwent ablation using the standardized PICENO AVNRT approach between 2017 and 2025. The protocol integrates Koch's triangle pace mapping and voltage-bridge mapping to guide slow-pathway ablation. Acute success was achieved in 100% of patients. No transient or permanent AV block occurred. Fluoroscopy was not required in any case. Mean procedure time was 62 ± 14 min. At 30.5 ± 18.8 months of follow-up, one recurrence (0.7%) was observed. CONCLUSION: A standardized 3D-guided safety-driven workflow for AVNRT ablation is feasible and reproducible in a day-hospital setting, achieving excellent outcomes while eliminating fluoroscopy because of procedural reliability.
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Marchese et al. (2026) conducted an observational in Atrioventricular nodal re-entrant tachycardia (AVNRT) (n=150). Standardized PICENO AVNRT approach (3D-guided zero-fluoroscopy workflow) was evaluated on Acute success. The standardized 3D-guided zero-fluoroscopy PICENO AVNRT approach achieved 100% acute success with no AV block and a 0.7% recurrence rate over 30.5 months of follow-up.
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