Role of electrograms recorded from mini electrodes in catheter ablation of atrioventricular nodal reentrant tachycardia: a retrospective study

초록

BACKGROUND: Data on the role of electrograms (EGMs) recorded from mini electrodes (MEs) of the IntellaTip MiFi ablation catheter (Boston Scientific) are limited. We evaluated the additional value of MEs during slow-pathway ablation in atrioventricular nodal reentrant tachycardia (AVNRT). METHODS: Consecutive patients with AVNRT who underwent slow-pathway ablation using the MiFi catheter were included. A combined electroanatomical approach was used to identify the target site. During ablation, operators were blinded to the ME EGMs, and ME EGMs recorded immediately before the first radiofrequency (RF) application were evaluated retrospectively. RESULTS: Altogether, 61 patients with typical (n&#x2009;= 58), atypical (n&#x2009;= 2), or both (n&#x2009;= 1) of AVNRT were included. Successful slow-pathway ablation or modification was achieved in all patients, and 33 patients (54.1%) demonstrated a junctional rhythm during the first RF application. Atrial EGMs (> 0.05 mV) at the MEs were observed immediately before the first RF in 34 patients (55.7%). A significant association was identified between the presence of atrial EGMs in MEs and the occurrence of junctional rhythm (odds ratio 13.5, P&#x2009;< 0.001). The positive and negative predictive values of atrial EGMs in the MEs for junctional rhythm induction during the first RF were 79.4% (27/34) and 77.8% (21/27), respectively. CONCLUSIONS: Atrial EGMs recorded from MEs before the first RF application could help identify effective ablation sites during slow-pathway ablation. Junctional rhythm was more frequently induced at sites with discernible ME signals, whereas sites without measurable ME EGMs despite adequate bipolar signals were less effective. These findings are limited to the initial RF application and warrant further validation. © 2025. The Author(s).

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