Temperature-guided slow AV nodal pathway ablation significantly reduced mean ablation time (19.9 vs 30.9 min, P<=0.02) and prevented coagulum formation compared to non-temperature-guided ablation.
Cohort (n=82)
Absolute Event Rate: 19.9% vs 30.9%
p-value: p=<=0.02
Thirty-nine consecutive patients with symptomatic AV nodal reentrant tachycardia (AVNRT) underwent temperature guided slow AV nodal pathway ablation (group 1). Forty-three consecutive patients undergoing nontemperature guided slow AV nodal pathway ablation late in our experience compose the control population (group 2). Slow pathway ablation was achieved in all patients of both groups. The mean fluoroscopy and ablation times for group 1 were significantly shorter than for group 2 (26.1 +/- 14.9 vs 33.9 +/- 18.9 min, P or = 50 degrees C for the remainder of patients (37/39 95%). The catheter ablation system used in this study was safe, effective, and prevented coagulum formation while delivering relatively high power. In addition, shorter ablation times and radiation exposure were seen with this system. Although successful energy applications and the production of junctional rhythm were associated with higher achieved temperatures, temperature alone did not predict either endpoint. Future prospective, randomized trials are needed to confirm these findings and further evaluate the value of temperature monitoring.
Epstein et al. (Sat,) conducted a cohort in symptomatic AV nodal reentrant tachycardia (AVNRT) (n=82). Temperature guided slow AV nodal pathway ablation vs. Nontemperature guided slow AV nodal pathway ablation was evaluated on mean ablation time (minutes) (p=<=0.02). Temperature-guided slow AV nodal pathway ablation significantly reduced mean ablation time (19.9 vs 30.9 min, P<=0.02) and prevented coagulum formation compared to non-temperature-guided ablation.
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