Anatomical considerations
The effective ablation rate was estimated at 90% by either strategy in
the total patients, indicating 10% of the patients with the EVA sites
over 5.7mm to PVVJ required a specific strategy. For the patient with
the EVA site 8.5mm beneath the PVVJ, the subvalvular strategy was
preferred (Supplementary Figure 1). For the patient with the EVA site
5.9mm above PVVJ, the supravalvular strategy was preferred
(Supplementary Figure 2). For the patient with EVA site in PA, either
strategy worked (Supplementary Figure 3). A few patients still had IA
failure by ipsilateral IA because catheter stability is also a
prerequisite for successful ablation. When the VA origins were close to
the PVVJ, the two strategies may have equal ablation effectiveness. The
strategy with better catheter stability may be preferred.