Arrhythmias & electrophysiology
Combination of slow pathway late activation maps and voltage gradient maps in guidance of atrioventricular nodal reentrant tachycardia cryoablation
Authors' conclusion
For AVNRT cryoablation, SPLAM could effectively guide the localization of slow pathway ablation sites and was particularly beneficial in patients with multiple slow pathways.
Study context
- Population
- Consecutive patients with atrioventricular nodal reentry tachycardia (AVNRT) undergoing cryoablation (age 16.5 ± 8.2 and 15.5 ± 7.3 years)
- Participants
- 36 vs 37
- Exposure
- Study vs Control
- Studyn = 36
- Controln = 37reference
- Outcome
- Procedural effectiveness
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
| Group | Value | Cryomapping attempts (median) | Cryoablation applications (median) |
|---|---|---|---|
| Study | 100% | 3 | 1 |
| Control | 100% | 5 | 2 |
Value
Study100%
Control100%
Cryomapping attempts (median)
Study3
Control5
Cryoablation applications (median)
Study1
Control2
- Study vs Control: P = 0.012 — cryomapping attempts
- Study vs Control: P < 0.001 — cryoablation applications
Observational data: associations, not effects.
Further findings
Recurrence · median follow-up 14.6 (study) and 18.3 (control) months
P = 0.402
Total procedural time and acute success
- Total procedural times comparable
Koch triangle mapping (study procedure)
- Mapping time (minutes)
- 11.8 ± 3.6
- Points collected
- 1562 ± 581
Agreement of mapping targets with final successful lesion site
- Low-voltage bridge (LVB) could not be defined
- 6 patients (16.7%)
- LVB not compatible with final successful lesion
- 6 (16.7%)
- Slow pathway late activation mapping (SPLAM) wave collision point defined and compatible with final successful lesion site in all patients, incl. multiple slow pathways
Original publication
Combination of slow pathway late activation maps and voltage gradient maps in guidance of atrioventricular nodal reentrant tachycardia cryoablation. Heart Rhythm. Published 17 April 2023. doi:10.
Summarised from the published abstract; every number is checked against it