Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
High-density electroanatomic mapping-guided ablation in AVNRT: the role of slow pathway late activation mapping technique.
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Sahin Ahmet Taha, Ozyesil Busra, Kan Hasan, Keskin Oznur, Sertdemir Ahmet Lutfu, Gul Enes Elvin
Аннотация
BACKGROUND: Slow Pathway Late Activation Mapping (SLAM) with high-density mapping catheters is a novel electroanatomical technique designed to identify the slow pathway region in atrioventricular nodal reentrant tachycardia (AVNRT). Its comparative efficacy and safety in adults remain underexplored.
METHODS: This single-center retrospective study included 91 patients with typical AVNRT who underwent catheter ablation. Patients were assigned to either SLAM-guided fluoroless ablation (n = 41) or conventional fluoroscopy-guided ablation (n = 50). Procedural characteristics, acute success, complication rates, and follow-up outcomes were analyzed.
RESULTS: Both groups achieved 100% acute procedural success. No fluoroscopy was used in the SLAM group except in 4 cases, while the control group had a mean fluoroscopy time of 9.39 ± 7.34 min. One patient in the control group developed complete atrioventricular block requiring left bundle branch area pacing. The SLAM group had significantly longer procedure times (p = 0.019) but showed comparable improvement in electrophysiological parameters. No recurrences were observed in the SLAM group during a median 10-month follow-up.
CONCLUSION: SLAM-guided fluoroless ablation is a safe and effective alternative to conventional fluoroscopy-guided AVNRT ablation. It enables high-resolution, physiologically guided targeting of the slow pathway while significantly minimizing radiation exposure.
METHODS: This single-center retrospective study included 91 patients with typical AVNRT who underwent catheter ablation. Patients were assigned to either SLAM-guided fluoroless ablation (n = 41) or conventional fluoroscopy-guided ablation (n = 50). Procedural characteristics, acute success, complication rates, and follow-up outcomes were analyzed.
RESULTS: Both groups achieved 100% acute procedural success. No fluoroscopy was used in the SLAM group except in 4 cases, while the control group had a mean fluoroscopy time of 9.39 ± 7.34 min. One patient in the control group developed complete atrioventricular block requiring left bundle branch area pacing. The SLAM group had significantly longer procedure times (p = 0.019) but showed comparable improvement in electrophysiological parameters. No recurrences were observed in the SLAM group during a median 10-month follow-up.
CONCLUSION: SLAM-guided fluoroless ablation is a safe and effective alternative to conventional fluoroscopy-guided AVNRT ablation. It enables high-resolution, physiologically guided targeting of the slow pathway while significantly minimizing radiation exposure.