The benefit of tissue contact monitoring with an electrical coupling index during ablation of typical atrial flutter—a prospective randomised control trial
| Autor: | Norman Qureshi, Kelvin C.K. Wong, Timothy R. Betts, Yaver Bashir, D Webster, Kim Rajappan, Christopher Hayes, Michael A. Jones |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Sensitivity and Specificity Inferior vena cava Monitoring Intraoperative Physiology (medical) Typical atrial flutter medicine Humans Fluoroscopy Prospective Studies Prospective cohort study Aged Tricuspid valve medicine.diagnostic_test business.industry Body Surface Potential Mapping Reproducibility of Results medicine.disease Ablation Surgery Catheter Treatment Outcome medicine.anatomical_structure Atrial Flutter medicine.vein Catheter Ablation Female Cardiology and Cardiovascular Medicine business Atrial flutter |
| Zdroj: | Journal of Interventional Cardiac Electrophysiology. 41:237-244 |
| ISSN: | 1572-8595 1383-875X |
| DOI: | 10.1007/s10840-014-9943-6 |
| Popis: | We sought to investigate the use of tissue contact monitoring by means of the electrical coupling index (ECI) in a prospective randomised control trial of patients undergoing cavotricuspid isthmus (CTI) ablation for atrial flutter. Patients with ECG-documented typical flutter undergoing their first CTI ablation were randomised to ECI™-guided or non-ECI™-guided ablation. An irrigated-tip ablation catheter was used in all cases. Consecutive 50-W, 60-s radiofrequency lesions were applied to the CTI, from the tricuspid valve to inferior vena cava, with no catheter movement permitted during radiofrequency (RF) delivery. The ablation endpoint was durable CTI block at 20 min post-ablation. Patients underwent routine clinic follow-up post-operatively. A total of 101 patients (79 male), mean age 66 (+/−11), 50 ECI-guided and 51 control cases were enrolled in the study. CTI block was achieved in all. There were no acute complications. All patients were alive at follow-up. CTI block was achieved in a single pass in 36 ECI-guided and 30 control cases (p = 0.16), and at 20 min post-ablation, re-conduction was seen in 5 and 12 cases, respectively (p = 0.07). There was no significant difference in total procedure time (62.7 ± 33 vs. 62.3 ± 33 min, p = 0.92), RF requirement (580 ± 312 vs. 574 ± 287 s, p = 0.11) or fluoroscopy time (718 ± 577 vs. 721 ± 583 s, p = 0.78). After 6 ± 4 months, recurrence of flutter had occurred in 1 (2 %) ECI vs. 8 (16 %) control cases (OR 0.13, 95 % CI 0.01–1.08, p = 0.06). ECI-guided CTI ablation demonstrated a non-statistically significant reduction in late recurrence of atrial flutter, at no cost to procedural time, radiation exposure or RF requirement. |
| Databáze: | OpenAIRE |
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