The advantage of the mini-electrode-equipped catheter for the radiofrequency ablation of paroxysmal supraventricular tachycardia

Young Choi, Sung Hwan Kim, Hwajung Kim, Jeong Wook Park, Young Woong Ha, Youmi Hwang, Ji Hoon Kim, Sung Won Jang, Yong Seog Oh

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

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 (RFA) of paroxysmal supraventricular tachycardias (PSVTs). Methods: We prospectively enrolled 136 patients undergoing RFA 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 ME catheters) or the control group (ablation using conventional catheters). 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 syndromes were compared. Results: During ablation procedures, discrete slow pathway 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 =.032; ablation time: 23.5 [5.0–111.5] vs. 64.5 [16.0–185.0] s, p =.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 were nonsignificantly lower in the ME group. Conclusion: The novel ME catheter was advantageous for identifying pathway potentials and reducing initial ablation attempt number and ablation time to reach acute ablation endpoint for PSVTs (ClinicalTrials.gov number, NCT04215640).

Original languageEnglish
Pages (from-to)2164-2171
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume33
Issue number10
DOIs
StatePublished - Oct 2022

Bibliographical note

Funding Information:
We would like to thank Cheol Min Moon, Boston Scientific Korea Electrophysiology Division, for his comments on the mechanics of ablation catheters used in the study.

Publisher Copyright:
© 2022 Wiley Periodicals LLC.

Keywords

  • Wolff−Parkinson−White syndrome
  • atrioventricular nodal reentrant tachycardia
  • atrioventricular reentrant tachycardia
  • paroxysmal supraventricular tachycardia
  • radiofrequency catheter ablation

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