Long sheath (LS) can contribute to stabilisation of ablation catheter during slow pathway ablation (SPA). There is no clear data about its clinical advantages of LS in SPA in literature.
Methods: We retrospectively compared immediate and long-term outcomes of 211 consecutive patients (pts) underwent SPA . In 97 pts (46%) long preshaped sheath (SJM, SR0) was used (group1) and in 114 pts (54%) (group 2) LS was not used.
Baseline characteristics: 61% women, mean age 54.2±14.5 years. The success rate of SPA was 98.6%. In 101 pts (49%) SP was completely ablated, in others the SP was modified. In 3.3% of the procedures there were short episodes of transient AV or CRBBB. During follow up period of 34.7±21.9 month, in 1.9% of pts AVNRT reoccurs. 6 patients underwent re-do procedures. Pts in group 1 had higher incidence of valve disease before the ablation (9.7% vs. 3%, p<0.03), history of atrial fibrillation (12.3% vs. 4.1%, p<0.017). There were no significant differences in other baseline characteristics.
Results: There were no significant differences in success rate, rate of SP modification or transient CRBBB between the groups. There was trend for less events of transient AVB with LS (1.75% vs. 5.15%, P<0.08). At the same time, usage of LS was significantly associated with less number of ablation catheters per procedure (1.75% vs. 11.3% of pts more than 1 catheter was used, p<0.0019). No case of recurrence was recognized in group 1 vs. 4.1% in group 2 (p<0.013). There were more re-do procedures for unsuccessful and recurrent cases in group 2 (5.1% vs. 0.87%, p=0.054).
Conclusions: In pts who underwent SPA, the usage of LS significantly reduces the need in multiple ablation catheters per procedure and the incidence of recurrence.
