Catheter Ablation of Right-Sided Accessory Pathways in Adults Using the Three-Dimensional Mapping System: A Randomized Comparison to the Conventional Approach
Three-dimensional (3D) mapping and navigation systems have been widely used for the ablation of atrial fibrillation and ventricular tachycardia, but the applicability of these systems for the ablation of supraventricular tachycardia (SVT) due to right-sided accessory pathways (RAPs) remains unknown....
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| description | Three-dimensional (3D) mapping and navigation systems have been widely used for the ablation of atrial fibrillation and ventricular tachycardia, but the applicability of these systems for the ablation of supraventricular tachycardia (SVT) due to right-sided accessory pathways (RAPs) remains unknown. The goal of this prospective randomized study was to compare the safety, efficiency, and efficacy of nonfluoroscopic and conventional fluoroscopic mapping techniques in guiding catheter ablation of SVT due to RAPs. Of the 393 consecutive patients with SVT who were randomized to receive either conventional fluoroscopic or Ensite NavX mapping-guided ablation, 64 patients with RAPs were included for analysis. Endpoints for ablation were no evidence of RAP conduction and no inducible atrioventricular reentrant tachycardia (AVRT). The 3D group showed fewer ablation pulses and a shorter total ablation time compared to the conventional group, although the acute procedural success did not differ significantly between the two groups. Total procedure time, electrophysiological study time, total fluoroscopy time, and cumulative radiation doses were also significantly reduced in the 3D group. Patients in the conventional group with a right atrium diameter (RAD) ≥ 47 mm required a longer fluoroscopy time. There was no significant difference in the recurrence rates between the two groups over a follow-up period of 3 to 29 months. There were no permanent complications. The 3D mapping system may be a preferred alternative for patients with AVRT due to RAPs, especially for patients with a large RAD (≥ 47 mm). |
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The goal of this prospective randomized study was to compare the safety, efficiency, and efficacy of nonfluoroscopic and conventional fluoroscopic mapping techniques in guiding catheter ablation of SVT due to RAPs. Of the 393 consecutive patients with SVT who were randomized to receive either conventional fluoroscopic or Ensite NavX mapping-guided ablation, 64 patients with RAPs were included for analysis. Endpoints for ablation were no evidence of RAP conduction and no inducible atrioventricular reentrant tachycardia (AVRT). The 3D group showed fewer ablation pulses and a shorter total ablation time compared to the conventional group, although the acute procedural success did not differ significantly between the two groups. Total procedure time, electrophysiological study time, total fluoroscopy time, and cumulative radiation doses were also significantly reduced in the 3D group. Patients in the conventional group with a right atrium diameter (RAD) ≥ 47 mm required a longer fluoroscopy time. There was no significant difference in the recurrence rates between the two groups over a follow-up period of 3 to 29 months. There were no permanent complications. The 3D mapping system may be a preferred alternative for patients with AVRT due to RAPs, especially for patients with a large RAD (≥ 47 mm).</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0128760</identifier><identifier>PMID: 26083408</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Ablation ; Ablation (Surgery) ; Adult ; Adults ; Atrial fibrillation ; Atrium ; Cardiac arrhythmia ; Cardiology ; Cardiovascular disease ; Catheter Ablation - instrumentation ; Catheter Ablation - methods ; Catheters ; Clinical trials ; Complications ; Conduction ; Efficiency ; Electrocardiography ; Electrophysiological recording ; Female ; Fibrillation ; Fluoroscopy ; Fluoroscopy - methods ; Heart ; Heart Atria - diagnostic imaging ; Heart Atria - pathology ; Heart Atria - surgery ; Humans ; Male ; Mapping ; Medical instruments ; Middle Aged ; Navigation systems ; Patients ; Pediatrics ; Radiation ; Radiofrequency ablation ; Randomization ; Recurrence ; ROC Curve ; Studies ; Success ; Surgery, Computer-Assisted - instrumentation ; Surgery, Computer-Assisted - methods ; Tachycardia ; Tachycardia, Supraventricular - diagnostic imaging ; Tachycardia, Supraventricular - pathology ; Tachycardia, Supraventricular - surgery ; Time Factors ; Treatment Outcome ; Veins & arteries ; Ventricle</subject><ispartof>PloS one, 2015-06, Vol.10 (6), p.e0128760-e0128760</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Ma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Ma et al 2015 Ma et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-a4894cd04096900b7089fc85e5a94514ad5f68c9ae54e925d1d0dc2cb5e4230d3</citedby><cites>FETCH-LOGICAL-c758t-a4894cd04096900b7089fc85e5a94514ad5f68c9ae54e925d1d0dc2cb5e4230d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471277/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471277/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23868,27926,27927,53793,53795</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26083408$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Cavarretta, Elena</contributor><creatorcontrib>Ma, Yuedong</creatorcontrib><creatorcontrib>Qiu, Jia</creatorcontrib><creatorcontrib>Yang, Yang</creatorcontrib><creatorcontrib>Tang, Anli</creatorcontrib><title>Catheter Ablation of Right-Sided Accessory Pathways in Adults Using the Three-Dimensional Mapping System: A Randomized Comparison to the Conventional Approach</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Three-dimensional (3D) mapping and navigation systems have been widely used for the ablation of atrial fibrillation and ventricular tachycardia, but the applicability of these systems for the ablation of supraventricular tachycardia (SVT) due to right-sided accessory pathways (RAPs) remains unknown. The goal of this prospective randomized study was to compare the safety, efficiency, and efficacy of nonfluoroscopic and conventional fluoroscopic mapping techniques in guiding catheter ablation of SVT due to RAPs. Of the 393 consecutive patients with SVT who were randomized to receive either conventional fluoroscopic or Ensite NavX mapping-guided ablation, 64 patients with RAPs were included for analysis. Endpoints for ablation were no evidence of RAP conduction and no inducible atrioventricular reentrant tachycardia (AVRT). The 3D group showed fewer ablation pulses and a shorter total ablation time compared to the conventional group, although the acute procedural success did not differ significantly between the two groups. Total procedure time, electrophysiological study time, total fluoroscopy time, and cumulative radiation doses were also significantly reduced in the 3D group. Patients in the conventional group with a right atrium diameter (RAD) ≥ 47 mm required a longer fluoroscopy time. There was no significant difference in the recurrence rates between the two groups over a follow-up period of 3 to 29 months. There were no permanent complications. The 3D mapping system may be a preferred alternative for patients with AVRT due to RAPs, especially for patients with a large RAD (≥ 47 mm).</description><subject>Ablation</subject><subject>Ablation (Surgery)</subject><subject>Adult</subject><subject>Adults</subject><subject>Atrial fibrillation</subject><subject>Atrium</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Catheter Ablation - instrumentation</subject><subject>Catheter Ablation - methods</subject><subject>Catheters</subject><subject>Clinical trials</subject><subject>Complications</subject><subject>Conduction</subject><subject>Efficiency</subject><subject>Electrocardiography</subject><subject>Electrophysiological recording</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Fluoroscopy</subject><subject>Fluoroscopy - methods</subject><subject>Heart</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Heart Atria - pathology</subject><subject>Heart Atria - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Mapping</subject><subject>Medical instruments</subject><subject>Middle Aged</subject><subject>Navigation systems</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Radiation</subject><subject>Radiofrequency ablation</subject><subject>Randomization</subject><subject>Recurrence</subject><subject>ROC Curve</subject><subject>Studies</subject><subject>Success</subject><subject>Surgery, Computer-Assisted - instrumentation</subject><subject>Surgery, Computer-Assisted - methods</subject><subject>Tachycardia</subject><subject>Tachycardia, Supraventricular - diagnostic imaging</subject><subject>Tachycardia, Supraventricular - pathology</subject><subject>Tachycardia, Supraventricular - surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Veins & arteries</subject><subject>Ventricle</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9tu1DAQhiMEoqXwBggsISG42MVOnMTuBVK0nCoVFfXAreW1JxtXSRxsp7A8DM-K091WXdQLZEWOxt__T2biSZLnBM9JVpJ3l3Z0vWzng-1hjknKygI_SPYJz9JZkeLs4Z33veSJ95cY5xkrisfJXlpgllHM9pM_CxkaCOBQtWxlMLZHtkanZtWE2ZnRoFGlFHhv3Rp9i-hPufbI9KjSYxs8uvCmX6HogM4bBzD7YDrofXSRLfoqh2E6PVv7AN0hqtCp7LXtzO_ourDdIJ3xMV-w1wYL219BHzbaahiclap5mjyqZevh2XY_SC4-fTxffJkdn3w-WlTHM1XmLMwkZZwqjSnmBcd4WWLGa8VyyCWnOaFS53XBFJeQU-BpronGWqVqmQNNM6yzg-TlxndorRfb1npBCsaLlKV5HomjDaGtvBSDM510a2GlEdcB61ZCumBUC0JBviy0qtkSMipjq8tSMijiw3PI0inb-222cdmBVrFsJ9sd092T3jRiZa8EpSVJyzIavNkaOPtjBB9EZ7yCtpU92HH6bo5TkhFOIvrqH_T-6rbUSsYCTF_bmFdNpqKihGW4oHyi5vdQcWnojIr3sDYxviN4uyOITIBfYSVH78XR2en_syffd9nXd9gGZBsab9txuj1-F6QbUDnrvYP6tskEi2mMbrohpjES2zGKshd3f9Ct6GZusr_4TBnK</recordid><startdate>20150617</startdate><enddate>20150617</enddate><creator>Ma, Yuedong</creator><creator>Qiu, Jia</creator><creator>Yang, Yang</creator><creator>Tang, Anli</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150617</creationdate><title>Catheter Ablation of Right-Sided Accessory Pathways in Adults Using the Three-Dimensional Mapping System: A Randomized Comparison to the Conventional Approach</title><author>Ma, Yuedong ; Qiu, Jia ; Yang, Yang ; Tang, Anli</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-a4894cd04096900b7089fc85e5a94514ad5f68c9ae54e925d1d0dc2cb5e4230d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Ablation</topic><topic>Ablation (Surgery)</topic><topic>Adult</topic><topic>Adults</topic><topic>Atrial fibrillation</topic><topic>Atrium</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Catheter Ablation - instrumentation</topic><topic>Catheter Ablation - methods</topic><topic>Catheters</topic><topic>Clinical trials</topic><topic>Complications</topic><topic>Conduction</topic><topic>Efficiency</topic><topic>Electrocardiography</topic><topic>Electrophysiological recording</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Fluoroscopy</topic><topic>Fluoroscopy - methods</topic><topic>Heart</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Heart Atria - pathology</topic><topic>Heart Atria - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Mapping</topic><topic>Medical instruments</topic><topic>Middle Aged</topic><topic>Navigation systems</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Radiation</topic><topic>Radiofrequency ablation</topic><topic>Randomization</topic><topic>Recurrence</topic><topic>ROC Curve</topic><topic>Studies</topic><topic>Success</topic><topic>Surgery, Computer-Assisted - instrumentation</topic><topic>Surgery, Computer-Assisted - methods</topic><topic>Tachycardia</topic><topic>Tachycardia, Supraventricular - diagnostic imaging</topic><topic>Tachycardia, Supraventricular - pathology</topic><topic>Tachycardia, Supraventricular - surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Veins & arteries</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ma, Yuedong</creatorcontrib><creatorcontrib>Qiu, Jia</creatorcontrib><creatorcontrib>Yang, Yang</creatorcontrib><creatorcontrib>Tang, Anli</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale in Context : Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database (Proquest)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Database (1962 - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ma, Yuedong</au><au>Qiu, Jia</au><au>Yang, Yang</au><au>Tang, Anli</au><au>Cavarretta, Elena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Catheter Ablation of Right-Sided Accessory Pathways in Adults Using the Three-Dimensional Mapping System: A Randomized Comparison to the Conventional Approach</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-06-17</date><risdate>2015</risdate><volume>10</volume><issue>6</issue><spage>e0128760</spage><epage>e0128760</epage><pages>e0128760-e0128760</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Three-dimensional (3D) mapping and navigation systems have been widely used for the ablation of atrial fibrillation and ventricular tachycardia, but the applicability of these systems for the ablation of supraventricular tachycardia (SVT) due to right-sided accessory pathways (RAPs) remains unknown. The goal of this prospective randomized study was to compare the safety, efficiency, and efficacy of nonfluoroscopic and conventional fluoroscopic mapping techniques in guiding catheter ablation of SVT due to RAPs. Of the 393 consecutive patients with SVT who were randomized to receive either conventional fluoroscopic or Ensite NavX mapping-guided ablation, 64 patients with RAPs were included for analysis. Endpoints for ablation were no evidence of RAP conduction and no inducible atrioventricular reentrant tachycardia (AVRT). The 3D group showed fewer ablation pulses and a shorter total ablation time compared to the conventional group, although the acute procedural success did not differ significantly between the two groups. Total procedure time, electrophysiological study time, total fluoroscopy time, and cumulative radiation doses were also significantly reduced in the 3D group. Patients in the conventional group with a right atrium diameter (RAD) ≥ 47 mm required a longer fluoroscopy time. There was no significant difference in the recurrence rates between the two groups over a follow-up period of 3 to 29 months. There were no permanent complications. The 3D mapping system may be a preferred alternative for patients with AVRT due to RAPs, especially for patients with a large RAD (≥ 47 mm).</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26083408</pmid><doi>10.1371/journal.pone.0128760</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-06, Vol.10 (6), p.e0128760-e0128760 |
| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; Public Library of Science; DOAJ Directory of Open Access Journals; PubMed Central; Free Full-Text Journals in Chemistry; EZB Electronic Journals Library |
| subjects | Ablation Ablation (Surgery) Adult Adults Atrial fibrillation Atrium Cardiac arrhythmia Cardiology Cardiovascular disease Catheter Ablation - instrumentation Catheter Ablation - methods Catheters Clinical trials Complications Conduction Efficiency Electrocardiography Electrophysiological recording Female Fibrillation Fluoroscopy Fluoroscopy - methods Heart Heart Atria - diagnostic imaging Heart Atria - pathology Heart Atria - surgery Humans Male Mapping Medical instruments Middle Aged Navigation systems Patients Pediatrics Radiation Radiofrequency ablation Randomization Recurrence ROC Curve Studies Success Surgery, Computer-Assisted - instrumentation Surgery, Computer-Assisted - methods Tachycardia Tachycardia, Supraventricular - diagnostic imaging Tachycardia, Supraventricular - pathology Tachycardia, Supraventricular - surgery Time Factors Treatment Outcome Veins & arteries Ventricle |
| title | Catheter Ablation of Right-Sided Accessory Pathways in Adults Using the Three-Dimensional Mapping System: A Randomized Comparison to the Conventional Approach |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-17T18%3A51%3A36IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Catheter%20Ablation%20of%20Right-Sided%20Accessory%20Pathways%20in%20Adults%20Using%20the%20Three-Dimensional%20Mapping%20System:%20A%20Randomized%20Comparison%20to%20the%20Conventional%20Approach&rft.jtitle=PloS%20one&rft.au=Ma,%20Yuedong&rft.date=2015-06-17&rft.volume=10&rft.issue=6&rft.spage=e0128760&rft.epage=e0128760&rft.pages=e0128760-e0128760&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0128760&rft_dat=%3Cgale_plos_%3EA418306495%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1689628255&rft_id=info:pmid/26083408&rft_galeid=A418306495&rft_doaj_id=oai_doaj_org_article_ce5b6dcf8be34a60877a8e6a8e95e32d&rfr_iscdi=true |