Comparison between conventional approach and three-dimensional mapping system in the catheter ablation of accessory
Shuang Zhang1, Zhihong Wu1, Mingxian Chen1
1Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China.
Insights
Three-dimensional (3D) mapping significantly improves catheter ablation for posteroseptal accessory pathways (APs) with coronary sinus (CS) diverticula. This advanced technique reduces procedure time, fluoroscopy exposure, and complications compared to conventional methods.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Technology
Background:
- Posteroseptal accessory pathways (APs) linked to coronary sinus (CS) diverticula pose rare challenges for catheter ablation.
- Effective ablation strategies are crucial for managing these complex cases.
Purpose of the Study:
- To compare the safety and efficacy of conventional catheter ablation versus three-dimensional (3D) mapping systems for posteroseptal APs associated with CS diverticula.
Main Methods:
- Retrospective analysis of patients undergoing catheter ablation for posteroseptal APs with CS diverticula between January 2013 and July 2022.
- Comparison between a conventional fluoroscopy group (n=13) and a 3D mapping group (n=11).
- Evaluation of clinical characteristics, procedural outcomes, complications, and recurrence rates.
Main Results:
- Out of 669 patients with posteroseptal APs, 3.6% (24 patients) had associated CS diverticula.
- The 3D mapping group demonstrated significantly shorter procedure and fluoroscopy times compared to the conventional group.
- No complications or recurrences were observed in the 3D mapping group during follow-up, unlike the conventional group.
Conclusions:
- Three-dimensional (3D) mapping systems offer superior outcomes for catheter ablation of posteroseptal accessory pathways (APs) associated with coronary sinus (CS) diverticula.
- 3D mapping enhances acute success rates, reduces procedure duration and fluoroscopy time, and lowers complication incidence.
Background:
Posteroseptal accessory pathways (APs) associated with coronary sinus (CS) diverticulum present a rare and challenge for ablation. This study aimed to compare the safety and efficacy of conventional approach and three-dimensional (3D) mapping system in the catheter ablation.
Methods And Results:
This was a retrospective study of all patients (from January 2013 to July 2022) who underwent catheter ablation of posteroseptal AP associated with CS diverticula in our center. Patients who underwent catheter ablation using the traditional fluoroscopy method were included in the conventional method group (n = 13). Patients who underwent catheter ablation using the 3D mapping method were included in the 3D mapping group (n = 11). Clinical characteristics, ablation procedure, and outcomes were recorded and analyzed between the two groups. Out of 669 patients with posteroseptal APs, 24 of them (3.6%) were associated with CS diverticula. All patients in both groups successfully completed the electrophysiological study. In the conventional method group, two patients experienced complications (one patient with pericardial effusion and the other patient with femoral arterial hematoma), and two patients had recurrence. However, no patients suffered from complications or recurrence during follow-up. The procedure time and fluoroscopy time in the conventional method group were significantly longer than those in the 3D mapping method group.
Conclusions:
The utilization of 3D mapping led to reduced fluoroscopy time, shorter procedure duration, enhanced acute success rates, and decreased incidence of complications.
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