Comparison of the Efficacy of Cooled‐Tip and 8‐mm‐Tip Catheters for Radiofrequency Catheter Ablation of the Cavotricuspid Isthmus: A Meta‐Analysis

Abstract

The present meta-analysis confirms that cooled-tip and large-tip catheters are equally efficient for cavotricuspid isthmus ablation with both similar primary success rates and procedure parameters.

“Largest Amplitude Ablation” is the Optimal Approach for Typical Atrial Flutter Ablation: A Subanalysis from the AURUM 8 Study

“…Conventional ablation technique requires creation of a complete line of conduction block (“pullback” ablation) across CTI, from the tricuspid valve to the inferior vena cava. This approach has a high overall success rate but results in variable, sometimes lengthy procedure times, mainly due to anatomic variation 2–5 . The recently proposed “maximum voltage‐guided” (MVG) ablation technique targets high‐voltage isthmus electrograms to ablate the functionally important anatomic muscle bundles alone, without drawing a complete anatomic line 6 .…”

Cavotricuspid Isthmus: Anatomy, Electrophysiology, and Long‐Term Outcome of Radiofrequency Ablation

“…Feld et al performed catheter ablation of type 1 atrial flutter using large‐tip electrode catheters in 169 patients and demonstrated that acute success rate is 93% and 97% patients had no recurrence of atrial flutter 18 . Furthermore, a meta‐analysis study confirmed that cooled‐tip and 8‐mm large‐tip catheters are equally efficient for CTI ablation with both similar primary success rates and procedure parameters 19 . Cryoablation of the CTI, as compared with radiofrequency ablation, produced significantly less pain during application of the energy.…”

Novel Strategies in the Ablation of Typical Atrial Flutter: Role of Intracardiac Echocardiography

“…A metaanalysis by Da Costa et al . [24] which included seven trials and 603 patients concluded that irrigated-tip and 8-mm-tip catheters are equally effective for isthmus ablation with similar success rates (84% vs.85%) and procedural characteristics (RFA time, fluoroscopy and total procedure time). “In the review article by Da Costa et al ., the authors concluded that 8-mm tip catheters seem to be more effective in patients with straight isthmus morphology and irrigated catheters appear to be more effective in cases of complex CTI anatomy” [25].…”

“…“This method has been accepted as a first-line therapeutic option in the treatment of CTI-dependent Afl and one of the most commonly performed procedures in electrophysiology” [5, 6]. RFA of CTI-dependent Afl is a highly successful intervention, but in about 1–12% of the patients the RFA remains unsuccessful [7-10]”. The principal obstacle to successful ablation is the complex and variable anatomy of the CTI which has been demonstrated in anatomical and angiographic studies” [5, 6].…”