Efficacy and safety of catheter ablation of atrioventricular nodal re-entrant tachycardia by means of flexible-tip irrigated catheters

Bertini, Matteo; Brieda, Alessandro; Balla, Cristina; Pollastrelli, Annalisa; Smarrazzo, Vittorio; Vitali, Francesco; Malagù, Michele; Ferrari, Roberto

doi:10.1007/s10840-019-00578-z

Cited by 10 publications

(19 citation statements)

References 20 publications

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“…Fluoroscopy time in our cohort was very low (99.7 s), due to the use of 3D EAM. This result is even lower than that previously reported of 106 s [17]. The progressive reduction in the use of fluoroscopy over time could be explained with the operator learning curve.…”

Section: Radiation Exposurecontrasting

confidence: 64%

“…In our cohort of 150 patients, acute procedural success rate was 96.7%. In a previous experience, which was the very first, among 80 patients, acute procedural success was 100% [17]. Walsh et al reported an acute success rate of 100% in 16 patients with AVNRT treated with the irrigated FlexAbility catheter and 3D EAM [20].…”

Section: Procedural Successmentioning

confidence: 98%

“…The combination of irrigation and flexible tip allows a stable contact with myocardial tissue with uniform delivery of radiofrequency and continued cooling [16]. In 2019, our group published an initial report about efficacy and safety of AVNRT ablation with a novel flexible-tip open-irrigated catheter (FlexAbility TM , Abbott, St. Paul, MN, USA) combined with a 3D EAM system (EnSite Precision TM , Abbott, St. Paul, MN, USA) [17].…”

Section: Introductionmentioning

confidence: 99%

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Ablation of Atrioventricular Nodal Re-Entrant Tachycardia Combining Irrigated Flexible-Tip Catheters and Three-Dimensional Electroanatomic Mapping: Long-Term Outcomes

Malagù¹,

Vitali²,

Marchini³

et al. 2021

JCDD

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Background: Transcatheter ablation is the standasrd treatment for atrioventricular nodal re-entrant tachycardia (AVNRT). However, different techniques are available. Data about the use of irrigated flexible-tip catheters and three-dimensional electroanatomical mapping (3D EAM) for AVNRT ablation are scant. The aim of this study was to evaluate in long-term follow-up efficacy and safety of a novel approach for AVNRT treatment. Methods: This is a cohort single arm study with long-term follow-up. Patients with AVNRT were treated with catheter ablation by means of irrigated flexible-tip catheters combined with 3D EAM. Results: One-hundred-and-fifty patients were enrolled and followed-up for a median of 38 months (minimum 12, maximum 74). Acute procedural success rate was 96.7% (145/150 patients). During follow-up, 11 patients had arrhythmia recurrences (7.3%). No patient developed atrioventricular conduction block with need for pacemaker implantation (0%). Fourteen patients died during follow-up (9.3%). Conclusions: Acute procedural success and long-term follow-up show that AVNRT could be safely and effectively treated with irrigated flexible-tip catheters and 3D EAM.

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Section: Radiation Exposurecontrasting

confidence: 64%

Section: Procedural Successmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Ablation of Atrioventricular Nodal Re-Entrant Tachycardia Combining Irrigated Flexible-Tip Catheters and Three-Dimensional Electroanatomic Mapping: Long-Term Outcomes

Malagù¹,

Vitali²,

Marchini³

et al. 2021

JCDD

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“…2 Elsewhere, researchers used a flexible-tip irrigated catheter for AVNRT ablation and similarly reported high levels of safety and efficacy. 3 A study of the biophysics at the catheter electrode-endocardial interface showed that saline-irrigated radiofrequency applications resulted in larger lesions by delaying or eliminating the impedance rise, despite the presence of electrode-endocardial interface boiling. Electrode coagulum was consistently associated with impedance rise, which was delayed or eliminated with irrigation.…”

Section: Discussionmentioning

confidence: 99%

Atrioventricular Nodal Reentrant Tachycardia Ablation with a Power-controlled, Contact-force Catheter

Contino¹,

Weiß²,

Riley³

et al. 2020

J Innov Cardiac Rhythm Manage.

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Radiofrequency catheter ablation is a safe and effective treatment option for atrioventricular nodal reentrant tachycardia (AVNRT). A nonirrigated ablation catheter used in a temperature-controlled mode is traditionally used for AVNRT ablation due to the shallow lesion depth required for successful slow-pathway ablation. In this case, a nonirrigated ablation catheter established inadequate lesions to ablate the slow pathway successfully. The adoption of an irrigated contact-force ablation catheter used in a power-controlled mode was necessary to provide higher power and possibly create a deeper lesion to ablate the slow pathway successfully, thus eliminating AVNRT inducibility in this patient.

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“…Bertini and colleagues 68 reported the use of a 4-mm-tip open-irrigated, flexible tip radiofrequency catheter (Therapy TM Cool Flex TM , Abbott Laboratories, Chicago, IL) for slow pathway ablation in patients with AVNRT. Settings included powers of 20-30 W with a maximum temperature of 43 C. Acute success was achieved in all 80 patients and there was 1 patient with recurrence.…”

Section: Technical Considerations For Catheter Ablationmentioning

confidence: 99%

Catheter ablation via the left atrium for atrioventricular nodal reentrant tachycardia: A narrative review

Wang

2021

Heart Rhythm O2

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Background Since 1996, it has been recognized that catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT) may require an approach through the left atrium. Objective The purposes are to present a case report and to provide a comprehensive narrative review on this topic. Methods A literature review of all articles that provided detailed information on patients who underwent catheter ablation via the left atrium for AVNRT was performed. The primary search queried PubMed using Medical Subject Headings (MeSH) terms “atrioventricular nodal reentrant tachycardia” and “left.” The secondary search was performed by manual review of reference lists and Google Scholar citations of manuscripts retrieved by the primary search. The review was limited to the English language. Results The searches yielded 30 articles that described 79 patients. A case report was added. Therefore, the final review consisted of 80 patients. The prevalence of left atrial ablation for patients with AVNRT undergoing catheter ablation at tertiary care centers was approximately 1%. Failed right atrial ablation, with or without coronary sinus ablation, was the most common indication for left atrial ablation. Pooled data from 3 cohort studies estimated the acute success rate for radiofrequency ablation of the slow pathway at the septal or inferoparaseptal segments of the mitral valve annulus after failed right-sided ablation to be 90%. There were no reports of atrioventricular block requiring permanent pacemaker implantation. Conclusion Catheter ablation of the slow pathway via the left atrium is an important technique for AVNRT cases that are refractory to conventional ablation.

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Efficacy and safety of catheter ablation of atrioventricular nodal re-entrant tachycardia by means of flexible-tip irrigated catheters

Cited by 10 publications

References 20 publications

Ablation of Atrioventricular Nodal Re-Entrant Tachycardia Combining Irrigated Flexible-Tip Catheters and Three-Dimensional Electroanatomic Mapping: Long-Term Outcomes

Ablation of Atrioventricular Nodal Re-Entrant Tachycardia Combining Irrigated Flexible-Tip Catheters and Three-Dimensional Electroanatomic Mapping: Long-Term Outcomes

Atrioventricular Nodal Reentrant Tachycardia Ablation with a Power-controlled, Contact-force Catheter

Catheter ablation via the left atrium for atrioventricular nodal reentrant tachycardia: A narrative review

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