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Erschienen in:

06.11.2023

A novel approach to typical atrioventricular nodal reentrant tachycardia with high-resolution mapping using the CARTO 3 cardiac mapping system

verfasst von: Kenta Takahashi, Taishi Kuwahara, Toshio Makita, Yayoi Ito, Yoshimi Oyagi, Kenta Kadono, Takuya Oshio, Ryo Takahashi

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 4/2024

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Abstract

Background

We hypothesized that high-resolution activation mapping during sinus rhythm (SR) in Koch’s triangle (KT) can be used to describe the most delayed atrial potential around the atrioventricular node and evaluated whether ablation targeting of this potential is safe and effective for the treatment of patients with typical atrioventricular nodal reentrant tachycardia (AVNRT).

Methods

We conducted a prospective, non-randomized, observational study using high-resolution activation mapping from the sinus node to KT with a PENTARAY or OCTARAY catheter using the CARTO 3 cardiac mapping system (Biosense Webster) during SR in 62 consecutive patients (22 men; age [mean ± standard deviation] = 55 ± 14 years) treated for typical AVNRT at our institution from August 2021 to March 2023.

Results

In all cases, the most delayed atrial potential was observed near the His potential within KT. Ablation targeting of this potential helped successfully treat each case of AVNRT, with a junctional rhythm observed at the ablation site. Initial ablation was deemed successful in 55/62 patients (89%); in the remaining seven patients, lesion expansion resolved AVNRT. One procedural complication occurred, namely, a transient atrioventricular block lasting 45 s. One patient experienced a transient tachycardic episode by the 1-month follow-up, but no further episodes were noted up to the 1-year follow-up.

Conclusion

Activation mapping at KT during SR with the high-resolution CARTO system clearly revealed the most delayed atrial potential near the His potential within KT. Targeting this potential was a safe and effective treatment method for patients with typical AVNRT in our study.
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Metadaten
Titel
A novel approach to typical atrioventricular nodal reentrant tachycardia with high-resolution mapping using the CARTO 3 cardiac mapping system
verfasst von
Kenta Takahashi
Taishi Kuwahara
Toshio Makita
Yayoi Ito
Yoshimi Oyagi
Kenta Kadono
Takuya Oshio
Ryo Takahashi
Publikationsdatum
06.11.2023
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 4/2024
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-023-01688-5

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