Major findings
We reported the first randomized controlled trial, which had
investigated the EVA site distribution and compared the ablation
effectiveness between the supravalvular strategy and the subvalvular
strategy in patients with idiopathic monomorphic RVOT-type VAs. Half of
the EVA sites were above the PVs, and most were within 10mm above PVVJ.
The two strategies did not differ in the IA success rates, ablation
applications, complications, and long-term VA recurrence. However, the
EVA site was an essential characteristic to determine the ablation
effectiveness of the two strategies. Ipsilateral IA remarkably increased
the success rate and reduced ablation applications.