Slow pathway radiofrequency ablation in patients with AVNRT: junctional rhythm is less frequent during magnetic navigation ablation than with the conventional technique.
BACKGROUND
The occurrence of accelerated junctional rhythm (JR) during radiofrequency ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia (AVNRT) is frequent. The aim of the present study was to compare the occurrence of JR during magnetic remote catheter ablation to the conventional manual ablation.


RESULTS
Twenty six patients (males: seven; age: 51 + or - 15 years) underwent slow pathway ablation with magnetic navigation (MN) system (Niobe, Stereotaxis Inc., St. Louis, MO, USA) and were compared to a control group of 11 patients (males: three; age: 53 + or - 16 years) treated with conventional manual ablation. A 4-mm nonirrigated tip catheter was used in both groups with a maximum of 30 W and 60 degrees C. Acute success was obtained in all patients. In the MN group, three patients out of 24 had no junctional beat (JB) at all and seven patients had 10 or less JB. In contrast, in the conventional group no patient had less than 10 JB. The mean number of JB in the MN group was 66 + or - 94.9 (0-410) and 200 + or - 243.1 (43-914) in the control group (P = 0.019). In the MN group one patient had a first-degree atrioventricular block. No other complication occurred.


CONCLUSIONS
Magnetic remote catheter ablation of AVNRT is effective and is associated with less JB than the manual conventional technique. Therefore, JB may not be considered as a mandatory indicator for successful AVNRT ablation with MN system.
Ricard
Philippe
P
Centre Hospitalier Princesse Grace, Division of Cardiology, Avenue Pasteur, 98000 Monaco, Principalty of Monaco. pricard@chpg.mc
Latcu
Decebal Gabriel
DG
Yaïci
Khelil
K
Zarqane
Naima
N
Saoudi
Nadir
N
D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome