Novel omnipolar mapping technology for effective superior vena cava isolation: A randomized clinical trial

Background

Successful isolation of the superior vena cava (SVC) using a functional conduction block between the right atrium (RA) and SVC has been documented. However, a comparison of this approach with the conventional method (CM) of circumferential ablation of the RA-SVC junction, based on angiography, remains unexplored.

Objective

In this study, we employed the innovative omnipolar mapping technology (OT) to discern the RA-SVC connection and compared clinical outcomes with those from CM.

Methods

Sixty-two patients undergoing SVC isolation were randomly assigned in a 1:1 ratio to either the OT or CM group. No significant differences in the baseline characteristics were observed between the two groups. We assessed the efficacy and safety of both groups.

Results

Both groups showed comparable acute success rates (96%) in SVC isolation, but the procedure in the OT group required fewer radiofrequency (RF) applications (13.6 ± 6.0 vs. 19.8 ± 10.9, p = .046) and shorter procedure time (9.6 ± 6.8 min vs. 14.3 ± 6.8 min, p = .007). The overall absorbed dose was notably lower in the OT group (69.6 ± 47.6 mGy vs. 90.3 ± 30.3 mGy, p = .023).

Conclusions

The OT enhances the efficacy of SVC isolation, requiring fewer RF applications and reducing procedure time compared to conventional treatment methods.