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Atrio-ventricular block (AVB) is a major complication of atrio-ventricular reentry tachycardia (AVNRT) ablation. Electro-anatomic mapping (EAM) ensures catheter stability, reducing X-rays. Our aim was to assess safety and efficacy of an irrigated, flexible tip catheter, guided by an EAM system, in AVNRT.
Seven patients (1 male, 14%; age 37±11 years) underwent an ablation, identifying fast and slow pathway locations by EnSite™ Velocity™. Standard deviation (SD) of the Flexability™ catheter tip position was studied to check its stability with and without irritating junctional rhythm during radiofrequency (RF).
Acute success rate was 100% without complications. Mean procedure/fluoroscopy times were 126±35min/148±255s, respectively. Mean RF time was 8.5±8.4 min. In 4/7 cases (57%) fluoroscopy was entirely avoided. Mean distance between RF applications and fast pathway was 18.3±7.9 mm; catheter position SD during RF was 0.7±0.3, 1.2±0.7, 1.1±0.6mm on x-y-z axes respectively.
This initial experience on a small cohort of young adults shows feasibility, safety and efficacy of EAM-guided AVNRT ablation. The associated use of a flexible, irrigated tip ensures catheter stability and accurate slow pathway mapping and ablation.