AVNRT applications 10 RF (55% vs. 68%, One pt w/ modification before applications p=NS) complete AV of AV node is alternative before block complete as effective as technique alternative All pts who during posterior the anterior technique failed initial lesion (fast path) approach approach, and were both successfully techniques treated by associated w/ alternative a low risk of technique w/o complications. developing high-grade AV Limiting to 1 h block or 10 attempts may underestimate success rates. 50 Anatomic EGM mapping AVNRT None stated Anatomic vs. N/A ITT analysis N/A The anatomic SJ of (n=25) (n= 25) mapping: Mapping vs. and mapping 1994 sequential RF in 84 anatomic: approaches (117) vs. energy Target sites vs. 100% for ablation of EGM applications along (p=0.1) Time the slow AV mapping (up to 12) posteromedial required for nodal for delivered tricuspid 4 w/ an ablation: pathway are AVNRT along tricuspid annulus near ineffective (28±21 vs. comparable in ablation annulus from coronary anatomic 31±31 min, efficacy and (slow level of the sinus ostium approach had p=0.7) duration. path) coronary a successful sinus ostium outcome w/ Duration of to His bundle mapping fluoroscopy: limited, and approach (27±20 vs. applicable 27±18 min, only to p=0.9) technique described Mean (e.g., authors number of cite not RF applicable for applications: expanded (6.3±3.9 vs. anatomic 7.2±8.0, approach or p=0.6) an EGM mapping approach that required the presence of a slow pathway potential).
AVNRT applications before alternative technique 10 RF applications before alternative technique (55% vs. 68%, p=NS) All pts who failed initial approach were successfully treated by alternative technique w/o developing high-grade AV block One pt w/ complete AV block complete during posterior lesion modification of AV node is as effective as the anterior (fast path) approach, and both techniques associated w/ a low risk of complications. Limiting to 1 h or 10 attempts may underestimate success rates. SJ 1994 (117) of vs. EGM mapping for AVNRT ablation (slow path) 50 Anatomic (n=25) sequential RF energy applications (up to 12) delivered along tricuspid annulus from level of the coronary sinus ostium to His bundle EGM mapping (n= 25) Target sites along posteromedial tricuspid annulus near coronary sinus ostium AVNRT None stated Anatomic vs. mapping: in 84 vs. 100% (p=0.1) 4 w/ an ineffective anatomic approach had a successful outcome w/ mapping approach N/A ITT analysis Mapping vs. anatomic: Time required for ablation: (28±21 vs. 31±31 min, p=0.7) Duration of fluoroscopy: (27±20 vs. 27±18 min, p=0.9) Mean number of RF applications: (6.3±3.9 vs. 7.2±8.0, p=0.6) N/A The anatomic and mapping approaches for ablation of the slow AV nodal pathway are comparable in efficacy and duration. limited, and applicable only to technique described (e.g., authors cite not applicable for expanded anatomic approach or an EGM mapping approach that required the presence of a slow pathway potential).