RT-227
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Cost reduction in
atrio-ventricular nodal reentry tachycardia radiofrequency catheter ablation
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Giuseppe Inama, Lorena Gramegna,
Paolo Pessano, Marcello Disertori.
Division of Cardiology, S. Chiara Hospital, Trento, Italy
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Abstract
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Aim of the study is to evaluate reliability,
advantages and costs of the radiofrequency catheter ablation procedure (RF) of
atrio-ventricular nodal reentrant tachycardia with slow pathway approach, using besides
the ablation catheter, a diagnostic transesophageal catheter for atrial stimulation and
recording. The transesophageal catheters are different from the endocavitary in that they
can be resterilized and thus reused.
Methods. Twenty consecutive patients who underwent a simplified
approach procedure (Group A) were compared to the 20 previous patients (Group B) who
underwent a "traditional procedure" with 3 diagnostic catheters plus ablator
catheter. We evaluated the differences in results, procedure and X-ray duration, number of
RF deliveries and complications.
Results. Group A procedures were quicker than Group B in overall
duration (65.7 ± 18.4 vs 115.5 ± 20.6 minutes; p < 0.001) and in X-ray duration (7.2
± 1.6 vs 15.2 ± 4 minutes; p < 0.001), while no significant difference was found in
the RF deliveries (2.8 ± 0.9 vs 2.5 ± 0.8). We had an acute 100% success ratio in both
groups with no complications. During the follow-up we observed no recurrence both in Group
A (9 ± 2 months) and in Group B (16 ± 2 months). The average procedure cost (only
catheters and introducer systems) for each patient was 1200 $ with the simplified approach
versus 2628 $ with the "traditional" approach (p < 0.001).
Conclusions. Using a transesophageal catheter for atrial pacing and
recording during single catheter RF ablation of atrio-ventricular nodal reentrant
tachycardia reduces procedure and X-ray time as well as the costs with no difference in
the procedure efficacy.
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Key Words
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Radio frequency catheter ablation of
tachyarrhythmias
atroventricular nodal reentrant tachycardia, slow pathway approach, transoesophageal
atrial pacing/recording, OA
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