| Objective: Radiofrequency catheter ablation (RFCA) has become one ofthe important therapies for patients with tachyarrhythmia. Compared withablation of left-sided APs, ablation of right-sided APs has lower success rateand higher recurrence rate, by reason of unique anatomical properties andelectrophysiological characteristics of right-sided APs. Recently improvedCarto-3system mapping can give the location precisely and can combine theanatomic and different types of electrophysiology information, so Carto-3maybe superior to the conventional mapping and can be used to guide ablation ofrefractory arrhythmia. However, whether ablation of right APs guided by threedimensional mapping is superior to the conventional mapping is not clear. Thepurpose of this study was to investigate whether Carto-3mapping has moreadvantages than conventional mapping through comparing the success rate,duration of procedure, fluoroscopic time and radiation dose.Methods:1Object:40patients with right-sided pathway (21males,19females)who were aged15to64were enrolled into this study between June2012andMarch2014at the Second Hospital of Hebei Medical University, including25patients proceeded by conventional RFCA and15patients proceeded byRFCA guided by the Carto-3system mapping. All of these patients hadexperiences of clinical tachycardia, one of them with Ebstein’s anomaly; therest had no documentation of structural heart disease.2All patients were examined using electrocardiogram before and afteroperation. All antiarrhythmic drugs were discontinued for at least fivehalf-lives before procedure. Electrophysiology study demonstrated right-sidedAPs in all the supraventricular tachycardia. The patients were separated into conventional group and Carto-3group. For all patients, we recorded proceduretime, which is defined as the interval from the initial insertion of the RFCAelectrode to procedural success. We also recorded cumulative fluoroscopictime, radiation dose, dose area product, success rate and short-term recurrencerate, and compared these data between the conventional group and Carto-3group.Statistical analysis: Statistical analysis was conducted with SPSS19.0software. The quantitative data were represented as mean±SD. The qualitativedata were represented as a percentage. The quantitative data was checkedusing independent samples t-test. The qualitative data was checked usingchi-square test or fisher test. The level of significance was set at0.05.Results: Compared with Carto-3group, the procedure time inconventional group was significantly longer (85.36±41.32min vs53.8±28.82min, P＜0.05). The fluoroscopic time was significantly longer in conventionalgroup than in Carto-3group (746.00±479.12s vs328.26±131.84s, P＜0.05).The radiation dose was significantly higher in conventional group than inCarto-3group (85.30±39.60mGy vs31.32±12.11mGy, P＜0.05). The successrate of conventional group was similar to that of Carto-3group (80%vs100%,P＞0.05). The short-term recurrence rate of conventional group was the sameas that of Carto-3group (9.5%vs6.7%, P＞0.05).Conclusion: Carto-3system mapping might be superior to conventionalmapping and can shorten the fluoroscopic time and radiation dose, andimproved the success rate. Carto-3system mapping is feasible, safe andeffective approach, especially applicable to patients with complex right-sidedAPs. Carto-3system mapping could be considered as the first approach ofablation with right-sided APs. |
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