The advantage of mini electrode-equipped catheter for the radiofrequency
ablation of paroxysmal supraventricular tachycardia
Abstract
Introduction: Novel ablation catheters equipped with
mini-electrodes (ME) offer high resolution mapping for target tissue.
This study aimed to evaluate the mapping performance and efficacy of ME
catheters in radiofrequency ablation of paroxysmal supraventricular
tachycardias (PSVTs). Methods: We prospectively enrolled 136
patients who were undergoing catheter ablation of PSVT including 76
patients with atrioventricular nodal reentrant tachycardia (AVNRT) and
60 patients with atrioventricular reentrant tachycardia (AVRT) or
Wolff-Parkinson-White (WPW) syndrome. Patients were randomized to the ME
group (ablation using a 4.5mm tip ME catheter) or the control group
(ablation using a conventional 4mm tip catheter). The number of ablation
attempt and cumulative ablation time to ablation endpoints, which was
defined as an emergence of junctional rhythm in AVNRT or accessory
pathway (AP) block in AVRT/WPW syndrome were compared. Results:
During ablation procedures, discrete SP or AP electrograms were found in
27 (39.7%) patients in the ME group and 13 (19.1%) patients in the
control group. The primary study outcomes were significantly lower in
the ME group (ablation attempt number: 2.0 [1–4] vs. 3.0 [2–7]
in the ME and control group, p=0.032; ablation time: 23.5
[5.0–111.5] vs. 64.5 [16.0–185.0] seconds, p=0.013). According
to the PSVT diagnosis, ablation time to junctional rhythm was
significantly shorter in the ME group in AVNRT. In AVRT/WPW syndrome,
both ablation attempt number and ablation time to AP block showed trends
favoring the ME group. Conclusion: The novel ME catheter was
advantageous for identifying pathway potentials and reducing initial
ablation attempt number and time in PSVT ablation. (ClinicalTrials.gov
number, NCT04215640)