3D Mapping Versus Conventional Ablation in AVNRT

This prospective randomized interventional study compared conventional fluoroscopy-guided slow pathway ablation versus three-dimensional electroanatomical mapping-guided ablation in patients with electrophysiologically confirmed typical atrioventricular nodal re-entrant tachycardia (AVNRT). A total of 108 patients were screened for eligibility, of whom 80 eligible patients were randomized in a 1:1 ratio to either conventional fluoroscopic ablation or 3D mapping-guided ablation. Following post-randomization dropouts, the final analysis included 38 patients in the conventional group and 36 patients in the 3D mapping group. The study evaluated fluoroscopy exposure, procedural efficacy, complete slow pathway elimination, procedural success, complications, and arrhythmia recurrence during follow-up.

Inclusion Criteria: * Sustained symptomatic supraventricular tachycardia with surface ECG features highly suggestive of atrioventricular nodal re-entrant tachycardia (AVNRT). * Electrophysiologically confirmed typical (slow-fast) AVNRT during the index electrophysiology study. * Ability to provide written informed consent. Exclusion Criteria: * Coexisting arrhythmia requiring concurrent catheter ablation during the same procedure. * Non-inducible AVNRT at the time of electrophysiological study. * Antiarrhythmic drug use within 48 hours before the procedure or ongoing amiodarone therapy. * Hemodynamic instability precluding safe catheter manipulation. * Pregnancy.