{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T20:52:23Z","timestamp":1780951943883,"version":"3.54.1"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Slow pathway (SP) ablation is the cornerstone for atrioventricular nodal reentry tachycardia (AVNRT) treatment, and a low-voltage bridge offers a good target during mapping using low x-ray exposure. We aimed to assess a new tool to identify SP by activation mapping using the last CARTO3\u00ae version, i.e., CARTO PRIME\u00ae V7 (Biosense Webster, Diamond Bar, CA, USA)<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Right atrial septum and triangle of Koch 3D-activation map were obtained from intracardiac contact mapping during low x-ray CARTO 3\u00ae procedure. In 60 patients (mean age 60.3\u2009\u00b1\u200914.7, 61% females) undergoing ablation for AVNRT, an automatic activation map using a DECANAV\u00ae mapping catheter and CARTO\u00ae Confidense\u2122, Coherent, and FAM DX software modules were obtained. The SP was identified in all patients as the latest atrioventricular node activation area; RF catheter ablation (RFCA) in that region elicited junctional beats. The mean procedural time was 150.3\u2009\u00b1\u200948.3\u2005min, the mean fluoroscopy time exposure was 2.9\u2009\u00b1\u20092\u2005min, the mean dose-area product (DAP) was 16.5\u2009\u00b1\u20092.7\u2005cGy\/cm<jats:sup>2<\/jats:sup>. The mean number of RF applications was 3.9\u2009\u00b1\u20092, the mean ablation index was 428.6\u2009\u00b1\u200996.6, and the mean contact force was 8\u2009\u00b1\u20092.8\u2005g. There were no adverse event during the procedure, and no AVNRT recurrences occurred during a mean follow-up of 14.3\u2009\u00b1\u20098.3 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ablation of the SP by automatic mapping using Confidense\u2122, Coherent, and FAM DX software modules is an innovative, safe, and effective approach to AVNRT ablation. The CARTO3\u00ae V7 system shows on a 3D map the latest AV node activation area during sinus rhythm allowing low fluoroscopy time and highly effective RFCA.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1144988","type":"journal-article","created":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T21:48:17Z","timestamp":1696110497000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Atrioventricular nodal reentry tachycardia treatment using CARTO 3 V7 activation mapping: a new era of slow pathway radiofrequency ablation is under coming"],"prefix":"10.3389","volume":"10","author":[{"given":"Enrico","family":"Chieffo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabato","family":"D\u2019Amore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"De Regibus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Dossena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Frigerio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Taravelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Ferrazzano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"De Iuliis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Cacucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio E.","family":"Landolina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.hrthm.2004.05.007","article-title":"Influence of age and gender on the mechanism of supraventricular tachycardia","volume":"1","author":"Porter","year":"2004","journal-title":"Heart Rhythm"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1016\/S0002-9149(02)02285-3","article-title":"Long-term outcomes on quality-of-life and health care costs in patients with supraventricular tachycardia (radiofrequency catheter ablation versus medical therapy)","volume":"89","author":"Goldberg","year":"2002","journal-title":"Am J Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1053\/euhj.2000.2124","article-title":"Targeting the slow pathway for atrioventricular nodal reentrant tachycardia: initial results and longterm follow-up in 379 consecutive patients","volume":"22","author":"Clague","year":"2001","journal-title":"Eur Heart J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1093\/europace\/eup121","article-title":"Treatment of atrioventricular nodal re-entrant tachycardia by cryoablation with a 6\u2005mm-tip catheter vs. radiofrequency ablation","volume":"11","author":"Chan","year":"2009","journal-title":"Europace"},{"key":"B5","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1093\/europace\/eux021","article-title":"Voltage gradient mapping and electrophysiologically guided cryoablation in children with AVNRT","volume":"20","author":"Drago","year":"2018","journal-title":"Europace"},{"key":"B6","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/0735-1097(93)90184-3","article-title":"Therapeutic end points for the treatment of atrioventricular node reentrant tachycardia by catheter-guided radiofrequency current","volume":"22","author":"Lindsay","year":"1993","journal-title":"J Am Coll Cardiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1093\/europace\/euu387","article-title":"Atypical atrioventricular nodal reentrant tachycardia: prevalence, electrophysiologic characteristics, and tachycardia circuit","volume":"17","author":"Katritsis","year":"2015","journal-title":"Europace"},{"key":"B8","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1093\/europace\/euaa195","article-title":"Low-voltage bridge strategy to guide cryoablation of typical and atypical atrioventricular nodal re-entry tachycardia in children: mid-term outcomes in a large cohort of patients","volume":"23","author":"Drago","year":"2021","journal-title":"Europace"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1093\/europace\/eur112","article-title":"Direct visualization of the slow pathway using voltage gradient mapping: a novel approach for successful ablation of atrioventricular nodal reentry tachycardia","volume":"13","author":"Bailin","year":"2011","journal-title":"Europace"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2820","DOI":"10.1161\/01.cir.90.6.2820","article-title":"Analysis of junctional ectopy during radiofrequency ablation of the slow pathway in patients with atrioventricular nodal reentry tachycardia","volume":"90","author":"Jentzer","year":"1994","journal-title":"Circulation"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.4022\/jafib.1044","article-title":"Risks related to fluoroscopy radiation associated with electrophysiology procedure","volume":"7","author":"Picano","year":"2014","journal-title":"J Atr Fibrillation"},{"key":"B12","doi-asserted-by":"publisher","first-page":"121","DOI":"10.15420\/aer.2020.02","article-title":"A new era in zero x-ray ablation","volume":"9","author":"Mascia","year":"","journal-title":"Arrhythm Electrophysiol Rev"},{"key":"B13","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/j.1540-8167.1994.tb01157.x","article-title":"Initiating re-entry: the role of non uniform anisotropy in small circuits","volume":"5","author":"Spach","year":"1994","journal-title":"J Cardiovasc Electrophysiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2351","DOI":"10.1161\/01.CIR.89.5.2351","article-title":"Origin and significance of double potentials near the atrioventricular node. Correlation of extracellular potentials, intracellular potentials and histology","volume":"89","author":"McGuire","year":"1994","journal-title":"Circulation"},{"key":"B15","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/j.hrthm.2023.01.004","article-title":"New insights into atrioventricular nodal anatomy, physiology, and immunochemistry: a comprehensive review and proposed model of the slow-fast atrioventricular nodal reentrant tachycardia circuit in agreement with direct potential recordings in the Koch\u2019s triangle area","volume":"20","author":"Pandozi","year":"2023","journal-title":"Heart Rhythm"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1016\/j.hrthm.2011.05.017","article-title":"Incidence and predictors of major complications from contemporary catheter ablation to treat cardiac arrhythmias","volume":"8","author":"Bohnen","year":"2011","journal-title":"Heart Rhythm"},{"key":"B17","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1111\/j.1540-8159.2011.03092.x","article-title":"Predictors of acute and long-term success of slow pathway ablation for atrioventricular nodal reentrant tachycardia: a single center series of 1,419 consecutive patients","volume":"34","author":"Feldman","year":"2011","journal-title":"Pacing Clin Electrophysiol"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1144988\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T21:48:19Z","timestamp":1696110499000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1144988\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,29]]},"references-count":17,"alternative-id":["10.3389\/fcvm.2023.1144988"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2023.1144988","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,29]]},"article-number":"1144988"}}