Introduction of Low-Voltage Bridge Mapping for Radiofrequency Ablation of AVNRT in Children: One-Year Follow-Up Results.

Background: Low-voltage bridge mapping (LVBM) is a recently introduced approach to atrioventricular nodal reentry tachycardia (AVNRT) ablation that may facilitate precise slow-pathway targeting. Our center implemented LVBM for radiofrequency (RF) AVNRT ablation in children in April 2023. Early results demonstrated procedural advantages without prolonging procedure time. Aim: The present study evaluates one-year follow-up outcomes after the introduction of LVBM. Methods: We retrospectively analyzed all pediatric AVNRT RF ablations performed between January 1, 2019, and August 31, 2024. Outcomes of procedures performed using a traditional approach were compared with those guided by LVBM. Clinical success, complications, RF application parameters, and total procedure time were assessed at one-year follow-up. Results: A total of 105 patients were included (61 controls, 44 LVBM). Baseline characteristics did not differ significantly between groups. At one-year follow-up, clinical success was higher in the LVBM group (90% vs. 80%), although the difference was not statistically significant. No complications were observed in either group. Conclusions: Introduction of low-voltage bridge mapping for RF AVNRT ablation in children reduces the number and duration of RF applications without prolonging procedure time. One-year follow-up demonstrates durable efficacy and safety, supporting LVBM as a valuable refinement of pediatric AVNRT ablation strategies.