Prospective evaluation of a simplified approach for common atrial flutter radio frequency ablation with only two catheters
| Autor: | S. Dennetiere, Salem Kacet, Dominique Lacroix, N Zghal, G H Mairesse, D Alix, Christelle Marquié, B d'Hautefeuille, Didier Klug |
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| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Radiofrequency ablation medicine.medical_treatment Catheter ablation Vena Cava Inferior Sensitivity and Specificity law.invention Catheterization QRS complex Electrocardiography law Predictive Value of Tests Recurrence Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans cardiovascular diseases Prospective Studies False Negative Reactions Aged medicine.diagnostic_test business.industry Atrial fibrillation Middle Aged Ablation medicine.disease Catheter Atrial Flutter cardiovascular system Cardiology Catheter Ablation Feasibility Studies Female Tricuspid Valve Cardiology and Cardiovascular Medicine business Atrial flutter Follow-Up Studies |
| Zdroj: | Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 3(3) |
| ISSN: | 1099-5129 |
| Popis: | Intra-atrial conduction block within the inferior vena cavatricuspid annulus isthmus (IVCT) has been shown to predict successful common atrial flutter ablation. However, its demonstration requires the use of several electrode catheters and mapping of the line of block. The aim of this study was prospectively to test the feasibility of a simplified ablation procedure using only two catheters. Methods Radio frequency (RF) ablation of common atrial flutter was performed in 30 patients with the sole use of a catheter for atrial pacing and a RF catheter. RF ablation lesions were created in the IVCT. Surface ECG criteria were used to monitor the conduction within the IVCT. The end point during low lateral atrial pacing was an increment in the interval between the pacing artefact and the peak of the R wave in surface lead II >50 ms and clockwise rotation of the P wave axis beyond 30 and inferiorly. Then, the line of lesions was mapped during atrial pacing with the RF catheter. Additional RF lesions were applied if mapping disclosed a zone of residual conduction. Otherwise the procedure was stopped if mapping showed parallel double potentials all along the line. Finally, the block was reassessed with a ‘Halo’ catheter. Results Surface ECG criteria were met in 26 patients. Mapping the line of lesions showed a complete corridor of parallel double potentials in these 26 cases and in 3 of the 4 patients in whom ECG criteria were not met. Conduction evaluated with the Halo catheter showed bi-directional complete block in these 29 patients. After a follow-up of 164 months there was no recurrence of atrial flutter. Conclusion Surface ECG criteria combined with mapping of the line of block demonstrate evidence of bi-directional IVCT block. This simplified RF ablation of common atrial flutter is feasible with a low recurrence rate. (Europace 2001; 3: 208–215) |
| Databáze: | OpenAIRE |
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