Evaluation of the operator learning curve for radiofrequency ablation for atrioventricular nodal reentrant tachycardia

Aim    The aim of this study was to determine the average minimum number of slow pathway ablation procedures required to reach a steady success rate among inexperienced operators.
Material and Methods    We analyzed the consecutive AVNRT ablation procedures of three inexperienced operators for the rate of operational success and complications.
Results    Operators performed a total of 156 AVNRT ablation procedures. There was no statistical significance between the three operators regarding the rate of success (p=0.69) and complications. There were significant differences between the operators in terms of procedure time, fluoroscopy time, and cumulative air kerma. The variability of procedure time and cumulative air kerma, both among three operators and within each operator, decreased significantly after the 25th case. Each operator was analyzed individually for the probability of success as related to the cumulative number of ablations. All trainee operators reached a success rate of 90 % at the 27th procedure.
Conclusion    An average of 27 slow pathway ablation procedures should be performed by a beginner operator to achieve proficiency.

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