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Background <p>Slow Pathway Late Activation Mapping (SLAM) with high-density mapping catheters is a novel electroanatomical technique designed to identify the slow pathway region in atrioventricular nodal reentrant tachycardia (AVNRT). Its comparative efficacy and safety in adults remain underexplored.</p> Methods <p>This single-center retrospective study included 91 patients with typical AVNRT who underwent catheter ablation. Patients were assigned to either SLAM-guided fluoroless ablation (<i>n</i> = 41) or conventional fluoroscopy-guided ablation (<i>n</i> = 50). Procedural characteristics, acute success, complication rates, and follow-up outcomes were analyzed.</p> Results <p>Both groups achieved 100% acute procedural success. No fluoroscopy was used in the SLAM group except in 4 cases, while the control group had a mean fluoroscopy time of 9.39 ± 7.34&#xa0;min. One patient in the control group developed complete atrioventricular block requiring left bundle branch area pacing. The SLAM group had significantly longer procedure times (<i>p</i> = 0.019) but showed comparable improvement in electrophysiological parameters. No recurrences were observed in the SLAM group during a median 10-month follow-up.</p> Conclusion <p>SLAM-guided fluoroless ablation is a safe and effective alternative to conventional fluoroscopy-guided AVNRT ablation. It enables high-resolution, physiologically guided targeting of the slow pathway while significantly minimizing radiation exposure.</p> Graphical Abstract <p></p>

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High-density electroanatomic mapping-guided ablation in AVNRT: the role of slow pathway late activation mapping technique

  • 期刊论文

  • 发表日期：

    2025年12月9日

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  • Ahmet Taha Sahin,
  • Busra Ozyesil,
  • Hasan Kan,
  • Oznur Keskin,
  • Ahmet Lutfu Sertdemir,
  • Enes Elvin Gul

摘要

Background

Slow Pathway Late Activation Mapping (SLAM) with high-density mapping catheters is a novel electroanatomical technique designed to identify the slow pathway region in atrioventricular nodal reentrant tachycardia (AVNRT). Its comparative efficacy and safety in adults remain underexplored.

Methods

This single-center retrospective study included 91 patients with typical AVNRT who underwent catheter ablation. Patients were assigned to either SLAM-guided fluoroless ablation (n = 41) or conventional fluoroscopy-guided ablation (n = 50). Procedural characteristics, acute success, complication rates, and follow-up outcomes were analyzed.

Results

Both groups achieved 100% acute procedural success. No fluoroscopy was used in the SLAM group except in 4 cases, while the control group had a mean fluoroscopy time of 9.39 ± 7.34 min. One patient in the control group developed complete atrioventricular block requiring left bundle branch area pacing. The SLAM group had significantly longer procedure times (p = 0.019) but showed comparable improvement in electrophysiological parameters. No recurrences were observed in the SLAM group during a median 10-month follow-up.

Conclusion

SLAM-guided fluoroless ablation is a safe and effective alternative to conventional fluoroscopy-guided AVNRT ablation. It enables high-resolution, physiologically guided targeting of the slow pathway while significantly minimizing radiation exposure.

Graphical Abstract