Non-fluoroscopic ablation of supraventricular tachycardia — results of a new approach

Keywords: supraventricular tachycardia, catheter ablation, non-fluoroscopic approach, intracardiac ultrasound

Abstract

Objective. To evaluate the efficacy and safety of catheter ablation of supraventricular tachycardia (SVT) using exclusively intracardiac ultrasound compared to conventional fluoroscopic approach.
Material and methods. There were 170 patients with SVT (85 patients in each group): 128 ones with atrioventricular nodal reentry tachycardia (AVNRT) and 42 ones with atrioventricular re-entry tachycardia (AVRT). In the non-fluoroscopic group, ablation
was performed under intracardiac ultrasound guidance. The follow-up period was 12 months.
Results. Intraoperative success rate was 100% in both groups. Freedom from recurrence was comparable among patients with
AVNRT (90.6% vs. 93.75%, p=0.74) and AVRT (95.2% vs. 95.2%). Safety of procedures was also similar (AVNRT 4.7% vs. 0%,
p=0.24; AVRT 0% vs. 0%). Fluoroscopy was used in none patient who underwent the procedure under intracardiac ultrasound
guidance (p < 0.001). However, surgery time and overall RF-ablation time was significantly shorter in the non-fluoroscopic group
among patients with AVNRT.
Conclusion. Catheter ablation of SVT under intracardiac ultrasound control is possible without fluoroscopy and electrophysiological navigation. This procedure is effective and safe.

Author Biographies

Sapelnikov Oleg Valerievich, Chazov National Medical Research Centre of Cardiology

Head of the Laboratory of Surgical and X-ray Surgical Methods for the Treatment of Cardiac Arrhythmias of the Department of Cardiovascular Surgery, MD, Researcher, Cardiovascular Surgeon of the Department of Cardiovascular Surgery 2016 - primary specialization in the specialty "X-ray endovascular diagnostics and treatment". 2008, 2010 – advanced training courses in Clinical Electrophysiology, Interventional and surgical Arrhythmology. 2002-2005 - postgraduate studies. OSSH of the Federal State Budgetary Institution "RKNPK" OF THE Ministry OF Health OF THE RUSSIAN Federation. 2000-2002 - clinical residency. OSSH of the Federal State Budgetary Institution "RKNPK" OF THE Ministry OF Health OF THE RUSSIAN Federation. Specialty "cardiovascular surgery". 1999-2000 - clinical internship. Bashkir State Medical University. Specialty "general surgery". 1993-1999 – Bashkir State Medical University - with honors. 2005 - present – Researcher at the OSSIC, doctor of cardiovascular Surgery at the OSSIC of the Federal State Budgetary Institution "NMICC" of the Ministry of Health of the Russian Federation. 2015 - awarded the first qualification category in the specialty "cardiovascular surgery". The range of interventions performed: Radiofrequency ablation of all cardiac arrhythmias, including with the use of all types of 3D navigation; cryoablation of AF using cryoballons of a new generation; implantation of pacemakers, cardioverters, defibrillators, cardioresynchronizing devices; electrode extraction surgery (including with artificial circulation); operation of myocardial revascularization, plastic surgery and prosthetics of valves heart disease in combination with surgical treatment of cardiac arrhythmias; operations of thoracoscopic AF ablation, surgical AF ablation from minidavage. 2005 - awarded the degree of Candidate of Medical Sciences in the specialty "cardiovascular surgery". He is the author and co-author of more than 120 scientific papers. He is the co-author of the monograph "Diseases of the Heart and Blood Vessels", ed. Academician E.I. Chasova.

Cherkashin Dmitry Igorevich, Chazov National Medical Research Centre of Cardiology

The doctor is a cardiovascular surgeon of the Department of Cardiovascular Surgery, Candidate of Medical Sciences 2016 - primary specialization in the specialty "X-ray endovascular diagnostics and treatment". 2011-2014 - postgraduate studies. OSSH of the Federal State Budgetary Institution "RKNPC" OF THE Ministry OF Health OF THE RUSSIAN Federation. 2008-2010 - clinical residency. OSSH of the Federal State Budgetary Institution "RKNPC" OF THE Ministry OF Health OF THE RUSSIAN Federation. Specialty "cardiovascular surgery". 2006-2007 - clinical internship. GBUZ VO "GKB of Emergency medical care" of Vladimir. Specialty "general surgery". 2000-2006 - Yaroslavl State Medical Academy. Specialty "medical business". 2009 - present - Doctor of cardiovascular surgery at the OSH of the Federal State Budgetary Institution "NMITSK" of the Ministry of Health of the Russian Federation. 2015 - awarded the first qualification category in the specialty "cardiovascular surgery". From 2007-2008, he worked as a general surgeon at the State Medical Institution of Higher Medical Education "GKB of Emergency Medical Care" in Vladimir. The range of interventions performed: Radiofrequency and cryoablation of various cardiac arrhythmias; implantation of pacemakers, cardioverters, defibrillators, cardioresynchronizing devices; individual stages of operations for myocardial revascularization and valve replacement. He is the author and co-author of more than 25 publications in Russian and international journals. Participates in protocols of clinical trials, Russian and international scientific conferences. The certificate in cardiovascular surgery is valid until March 2025.

Ardus Darin Faresovna, Chazov National Medical Research Centre of Cardiology

Junior Researcher at the Laboratory of Hybrid Methods of Treatment of Cardiovascular Diseases of the Department of Cardiovascular Surgery, Candidate of Medical Sciences In 2019, she graduated from the I.M. Sechenov Moscow Medical Academy with a degree in medical treatment, and in 2021, she completed her residency in cardiology. In 2024, she defended her PhD thesis. The accreditation in the specialty "cardiovascular surgery" is valid until September 2026.

Kulikov Alexander Andreevich, Chazov National Medical Research Centre of Cardiology

The doctor is a cardiovascular surgeon of the Department of Cardiovascular Surgery of the Federal State Budgetary Institution "NMITSK named after Academician E.I. Chazov" of the Ministry of Health of the Russian Federation In 2014, he graduated from the Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, a doctor specializing in medical practice. From 2014 to 2016, he completed his residency at the National Research Medical Center of Cardiology (formerly the Federal State Budgetary Institution "Russian Cardiological Research and Production Complex" of the Ministry of Health of the Russian Federation). He was qualified as a cardiovascular surgeon. Work experience: From 2016 to the present, he has been a cardiovascular surgeon at the Department of Cardiovascular Surgery of the Chazov National Research Medical Center of the Ministry of Health of the Russian Federation.

Vereshchagina Anna Vladimirovna, Chazov National Medical Research Centre of Cardiology

Cardiologist, PhD.

Grishin Igor Romanovich, Chazov National Medical Research Centre of Cardiology

The doctor is a cardiovascular surgeon of the Department of Cardiovascular Surgery, Candidate of Medical Sciences In 2001, he graduated from the Far Eastern State Medical University with a degree in general medicine, and in 2007, he completed postgraduate studies in cardiovascular surgery. He defended his PhD thesis in 2010. The range of performed interventions: Implantation of pacemakers, cardioverters, defibrillators, cardioresynchronizing devices; Electrode extraction surgery (including with artificial blood circulation)

Uskach Tatiana Markovna, Chazov National Medical Research Centre of Cardiology

Senior Researcher at the Department of Myocardial Diseases and Heart Failure, MD, Professor Scientific Secretary of the Dissertation Council on 21.1.029.02 on the basis of the Federal State Budgetary Institution "NMITSK named after Academician E.I. Chazov" of the Ministry of Health of the Russian Federation From 1999 to 2001, she studied in clinical residency at the Department of Internal Diseases at the Medical Institute of the Peoples' Friendship University of Russia, specializing in cardiology. From 2002 to 2004, she was a postgraduate student at the Department of Emergency Medicine of the Federal State Budgetary Educational Institution of Higher Medical Education named after A.I. Evdokimov of the Ministry of Health of the Russian Federation. In 2003, she defended her PhD thesis on "Thromboembolic complications in patients with chronic heart failure and the place of low-molecular-weight heparin enoxaparin in their prevention." From 2004 to 2008, she worked as an assistant, and from 2008 to 2015, she was an associate professor at the Department of Emergency Medicine at the Moscow State Medical University named after A.I. Evdokimov of the Ministry of Health of the Russian Federation. In 2013, she defended her doctoral thesis on the topic "The risk of anemia in patients with chronic heart failure, its prognostic significance and a differential approach to treatment." From 2015 to 2018, she worked in the Department of Myocardial Diseases and Heart Failure of the Federal State Budgetary Institution "NMIC of Cardiology" of the Ministry of Health of the Russian Federation as head of the department, since 2018 – as a leading researcher. Since 2019, he has been the Academic secretary of the Dissertation Council of the Chazov National Research Medical Center of the Ministry of Health of the Russian Federation. Professor of the Department of Cardiology of the Federal State Budgetary Educational Institution of Higher Professional Education. T.M. Uskach is the author of more than 160 publications, including 7 teaching aids and 6 chapters in monographs. The results of scientific work have been repeatedly reported at Russian and international conferences. Under the supervision of T.M. Uskach, 8 PhD theses were defended. The Hirsch index in the RSCI is 9.

Shiryaev Andrey Andreevich, Chazov National Medical Research Centre of Cardiology

Head of the Laboratory of Cardiac and Vascular Microsurgery, Chief Researcher of the Department of Cardiovascular Surgery, MD, Professor, Laureate of the State Prize of the Russian Federation and the State Prize of the Republic of Tatarstan, Corresponding Member and expert of the Russian Academy of Sciences

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Published
2025-03-10
How to Cite
Podyanov , M., Sapelnikov , O., Cherkashin , D., Ardus , D., Kulikov , A., Vereshchagina , A., Grishin , I., Uskach , T., Omelianenko , A., Ramazanov , H., Demurchev , M., Shiryaev , A., & Akchurin , R. (2025). Non-fluoroscopic ablation of supraventricular tachycardia — results of a new approach. Russian Cardiology Bulletin / Kardiologicheskii Vestnik, 19(4 часть 1), 80-86. Retrieved from http://ojs2.rucml.ru/index.php/ms-cardiovest/article/view/613
Issue
Vol. 19 No. 4 часть 1 (2024)
Section
Original articles