not-yet-known not-yet-known not-yet-known unknown Background: Radiofrequency catheter ablation (RFCA), guided by fluoroscopy, is the primary treatment for paroxysmal supraventricular tachycardia (PSVT). However, the accompanying concerns, such as radiation damage and vascular puncture complications caused by this traditional treatment method, have not been solved. Method: This retrospective study collected data from adults with atrioventricular nodal reentrant tachycardia (AVNRT) who underwent RFCA between June 2022 and October 2022. Patients were divided into two groups based on catheter access sites, the superior vena cava (SVC) group and the inferior vena cava (IVC) group. Outcomes were compared using an unpaired t-test or nonparametric test, and event-free survival analysis was conducted with the log-rank test. Results: A total of 31 patients were included, with 15 in the SVC group and 16 in the IVC group. Both groups achieved successful ablation. The SVC group had a longer operation time (86.0 vs. 64.6 minutes, p<0.01) but a shorter post-procedural hospital stay (17.52 vs. 23.52 hours, p=0.02). Relative costs were similar ( p=0.33). The SVC group did not require post-procedural bed rest, while the IVC group required an average of 6.6 hours. Vascular puncture events occurred in 12.5% of the IVC group but none in the SVC group. No deaths or major adverse cardiovascular events were reported. One-year follow-up showed similar long-term effects between SVC and IVC groups ( p=0.98). Conclusion: Zero-fluoroscopy RFCA via the SVC is safe and effective for treating AVNRT, reducing vascular complications and eliminating the need for bed rest compared to traditional RFCA via the lower extremity.