Abstract：Objective To compare and evaluate the feasibility and safety of the four clinically frequentlyused catheters during the process of nonfluoroscopic radiofrequency ablation of paroxysmal supraventricular tachycardia(PSVT) guided by EnSite Velocity threedimensional electroanatomical mapping system. MethodsWe selected 458 PSVT patients who had undergone radiofrequency ablation. Among those research objects, there were 263 patients with atrioventricular nodal reentrant tachycardia(AVNRT) resulting from dual atrioventricular nodal pathway(DAVNP)(DAVNP group), 48 patients with atrioventricular reentrant tachycardia(AVRT) caused by right accessory path(RAP)(RAP group) and 147 patients with AVRT resulting from left accessory path(LAP)(LAP group). According to the catheter used in the procedure, each group was further randomly classified into Johnson group, APT group, Medtronic group and St. Jude group. Nonfluoroscopic electrophysiologic study and radiofrequency ablation were performed within a limited period of time. The success rate of operation,incidence of complications and operation time of radiofrequency catheter were compared and analyzed. ResultsNonfluoroscopic radiofrequency ablation was completed in 379 patients(82.8%). The ablation time of DAVNP group was within 30 minutes. The operation time of the four brands of catheters was separately (17.71±4.58) min, (17.51±4.42) min, (17.32±5.34) min and (17.69±4.64) min, without statistically significant difference(P>0.05). Fortysix patients in RAP group completed the ablation within 60 minutes; the completion rate of the four brands of catheters was separately 91.7%, 100%, 100% and 91.7%, without statistically significant difference(P>0.05). Only 47.6% of patients in LAP group completed the procedure within 30 minutes; the success rate of the four brands of catheters was 88.9%, 54.1%, 32.4% and 13.5%; the rate of Johnson group was higher than that of other three groups(P<0.01); the incidence of complications was 1.1%. ConclusionIn the guidance of appropriate and familiar threedimensional mapping system, it is suggested to choose suitable ablation catheter according to the type of arrhythmia and operators habits. The four brands of catheters are all fit for the ablation of DAVNP and RAP,all with relatively high success rates. The nonNAV A bent(yellow handle) and B bent(red handle) catheters by Johnson & Johnson are recommended for LAP ablation. It proves to be feasible, safe and efficient to perform nonfluoroscopic radiofrequency ablation of PSVT guided by EnSite Velocity system.
2018, Vol. 27 
