Outcomes of cavotricuspid isthmus-dependent fLutter ablation: randomized study comparing single vs multiple catheter procedures. The SIMPLE study
| Autor: | G Falasconi, D Penela, A Chauca, J Fernandez-Armenta, R Pavon, J Acosta, J M Lozano, D Soto-Iglesias, J Marti-Almor, A Bellido, A Ordonez, D Viveros, J Alderete, P Francia, A Berruezo |
|---|---|
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Europace. 25 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Funding Acknowledgements Type of funding sources: None. Background Catheter ablation is recommended as first-line therapy for patients with symptomatic typical atrial flutter (AFl). Although the conventional multi-catheter approach is the standard of care for cavotricuspid isthmus (CTI) ablation, a single-catheter approach was recently described as a feasible alternative. Purpose The present study sought to compare safety, efficacy, and efficiency of single vs multi-catheter approach for AFl ablation. Methods In this randomized multicentre study, consecutive patients referred for AFl ablation (n= 253) were enrolled and randomized to multiple vs single-catheter approach for CTI ablation. In the single-catheter arm CTI block was confirmed analyzing PR interval (PRI) on the surface ECG as previously described by Madaffari and colleagues: briefly, PRI defined as the time between the pacing spike and the onset of the QRS complex, was measured on the surface ECG during atrial pacing (10 V, 1.5 ms) at a stable cycle length from the tip of the ablation catheter placed at 5 o’clock (medial to CTI line), 7 o’clock (lateral to CTI line), and 9 o’clock position. CTI block was assumed when: (i) the PRI at 7 o’clock was >80ms longer than that at pacing sites of 5, and (ii) the PRI at 9 o’clock was shorter than the PRI at 7 o’clock (Figure 1). Procedural and follow-up data were collected and compared between the two arms. Results 128 and 125 patients were assigned to the single-catheter and to the multi-catheter arms, respectively. In the single-catheter arm, procedure time was singificantly shorter (37±25 vs 48±27 minutes, p=0.002), required less fluoroscopy time (430±461 vs 712±628 seconds, p Conclusions Recurrence-free survival of the single-catheter approach for typical AFl ablation is not inferior to the conventional multiple-catheter approach, reducing procedure, fluoroscopy and radiofrequency time. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|