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To compare effectiveness and safety between three-dimensional electroanatomical mapping system (3D-EAMS)-assisted and conventional radiofrequency catheter ablation (RFCA) of atrioventricular nodal reentrant tachycardias (AVNRT).
108 patients were evenly randomized to undergo conventional or 3D-EAMS- assisted RFCA of AVNRT. Primary endpoint was acute procedural success; and secondary endpoints were freedom from supraventricular tachycardia (SVT) at 30 days, total procedure time, RF discharge time, fluoroscopy time, X-ray exposure, and procedural complication rate.
3D-EAMS-assisted vs. conventional RFCA of AVNRT was associated with statistically similar acute success, 30-day freedom from SVT, and procedure time (49.17±5.755 vs. 48.22±6.380 min, P =0.128); significantly shorter overall RF discharge time (153.65±25.975 vs. 249.33±39.750 sec, P <0.001), fluoroscopy time (153.65±25.975 vs. 1553.20±396.383 sec, P<0.001), and X-ray exposure (114.30±14.359 vs. 2006.13±372.917 mGy, P<0.001); and numerically but not significantly lower incidence of procedure-related AV block (P=0.059).
Use of 3D-EAMS as the primary source of catheter guidance during ablation of AVNRT is effective and safe and allows procedural standardization, and shorter RF discharge time and less radiation exposure than conventional RFCA.