Key result
Accessory pathway potential amplitude over 1.07 mV predicts successful coronary sinus ablation with ~90% specificity.
Why the study?
The optimal method for selecting the appropriate catheter type for coronary sinus ablation in accessory pathway-related supraventricular tachycardia is unclear.
Does the amplitude of the accessory pathway potential predict successful ablation time and guide catheter selection in coronary sinus ablation?
Observational (n=360)
No
Does the amplitude of the accessory pathway potential predict successful ablation time and guide catheter selection in coronary sinus ablation?
The amplitude of the accessory pathway potential can effectively guide the selection between temperature-controlled and irrigated-tip catheters for coronary sinus ablation, potentially reducing costs and tissue damage.
AP amplitude may guide TCC selection to limit damage and cost in CS ablation; leaves open prospective validation before practice change.
Background: The ablation of the coronary sinus (CS) is becoming more and more important in accessory pathway-related supraventricular tachycardia ablation. In comparison with temperature-controlled catheters (TCC), irrigated-tip catheter (ITC) are more expensive and cause more damage in accessory pathway-related supraventricular tachycardia ablation. We intended to develop a new method for the reasonable selection of electrode for coronary sinus(CS) ablation via assessing the relationship between the accessory pathway (AP) potential and time of successful ablation. Methods：Among the patients who had detected the bypass potential during radiofrequency ablation between 1/1/2015 and 12/31/2019. TCC was performed in 330 patients receiving endocardial ablation. 30 patients underwent radiofrequency catheter ablation (RFCA) in CS. The relationship between AP potential and time of successful ablation was analyzed. Results：330 cases of TCC ablation within the endocardium revealed that the amplitude of AP potential was significantly and negatively correlated with the time of successful ablation (r = -0.79, p < 0.001). In CS ablation, the median baseline amplitude of the AP potentials in patients with successful TCC ablation was higher than that in patients with ITC following TCC ablation failure (p = 0.02). The optimal cutoff value of the amplitude of the AP potential to guide the selection of a catheter for ablation was 1.07 mV, and the sensitivity and specificity were 80% and 90%, respectively. Conclusion：The AP potential is helpful for the electrode selection in CS ablation.
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Sun et al. (2020) conducted an observational in Accessory pathway-related supraventricular tachycardia (AP-SVT) (n=360). Accessory pathway (AP) potential amplitude vs. Low AP potential amplitude was evaluated on Prediction of successful temperature-controlled catheter (TCC) ablation in the coronary sinus (AUC 0.870, 95% CI 0.657-1.0, p=0.023). An accessory pathway potential amplitude cutoff of 1.07 mV predicted successful temperature-controlled catheter ablation in the coronary sinus with 80% sensitivity and 90% specificity.
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