Contact-force-guided vs. contact-force-blinded catheter ablation of typical atrial flutter: a prospective study

Venier, Sandrine; Andrade, Jason G.; Khairy, Paul; Mondésert, Blandine; Dyrda, Katia; Rivard, Léna; Guerra, Peter G.; Dubuc, Marc; Thibault, Bernard; Talajic, Mario; Roy, Denis; Macle, Laurent

doi:10.1093/europace/euw137

Cited by 18 publications

(41 citation statements)

References 19 publications

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“…Previous studies showed that large tip or irrigated tip catheters created larger lesions and were more effective than conventional catheters 17‐19 . Venier et al reported that contact force guided ablation reduced RF ablation time and facilitated the maintenance of homogenous efficient contact along the CTI 6 . Focusing on overcoming the complex anatomy of CTI, many imaging modalities have also been studied such as cardiac CT, angiography, and intracardiac echocardiography 7‐9 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of high‐power and short‐duration ablation for cavotricuspid isthmus ablation in atrial flutter

Kwon

Lee

Park

et al. 2020

Pacing Clinical Electrophis

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Background Despite many studies on new tools and strategies for cavotricuspid isthmus (CTI) ablation, there is an unmet need to improve the CTI ablation procedure. Recently, high‐power short‐duration (HPSD) ablation has been widely used for pulmonary vein (PV) isolation in atrial fibrillation. We evaluated the effectiveness and safety of HPSD for CTI ablation in atrial flutter (AFL). Methods Eighty‐four patients who underwent CTI ablation with or without simultaneous PV isolation between January 2018 and February 2019 were enrolled in this prospective cohort study. We compared procedural characteristics, periprocedural complications, and recurrence of atrial tachyarrhythmia (ATa) between the HPSD group (50 W for 15 s) and conventional group (30 W for 60 s). Results A total of 84 patients were divided into the HPSD (n = 42) and conventional (n = 42) groups. Bidirectional CTI block was achieved in all patients and 95% achieved bidirectional block after the first‐line ablation in both groups. Although there was no difference in the total number of ablation lines between the two groups (1.17 ± 0.7 vs 1.38 ± 0.8, P = .067), HPSD ablation significantly reduced total ablation time compared to the conventional group (236.0 ± 85.6 vs 534.2 ± 235.2 s, P < .001). One pericardial tamponade was reported in the HPSD group. During the mean follow‐up of 9.3 ± 4.8 months, CTI‐dependent AFL recurrence occurred in one patient in the HPSD group. Recurrence of ATa developed in 14 patients with no significant difference between the groups. Conclusion Our study demonstrates that HPSD CTI ablation is safe and can shorten procedure time.

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Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of high‐power and short‐duration ablation for cavotricuspid isthmus ablation in atrial flutter

Kwon

Lee

Park

et al. 2020

Pacing Clinical Electrophis

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“…Перипроцедурная эффективность РЧА КТИ высока, что обусловлено использованием ирригационных (орошаемых) абляционных катетеров и выполнением обязательной верификации двунаправленной блокады проведения волны деполяризации через нижний перешеек в ходе процедуры эндокардиального ЭФИ. Но при этом примерно в 5-15 % случаев требуется повторное вмешательство для достижения 100 % излечения от ТП [10,[62][63][64]. Рецидив ТП после РЧА наблюдается в 21 % случаев при неклассическом типичном внутриперешеечном micro re-entry [65].…”

Section: хирургическое лечение при трепетании предсердийunclassified

Atrial Flutter: up‐to‐date Problem Evaluation with Clinical Positions

et al. 2020

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The review provides current ideas about the etiology and prevalence of atrial flutter (AF), mechanism and substrate of arrhythmogenesis, and principles of clinical and electrophysiological classification of this arrhythmia. Methods for conservative and surgical treatments of AF, including their comparative aspect, are described in detail. The review presented recent data on efficacy and potential risks of different approaches to reversing the arrhythmia. The authors indicated a need for early diagnosis and strict control of the sinus rhythm in AF, which would help a successful intervention not only to completely cure the existing arrhythmia but also to prevent other heart rhythm disorders, primarily atrial fibrillation.

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“…52 More recently, contact-force guided catheters may also be used for CTIdependent AFL with a good efficacy and safety profile. 53,54 Some authors also used mini electrodes at the 8-mm tip of the ablation catheter for better discrimination of the local electrograms within the CTI. 55…”

Section: Technology Usedmentioning

confidence: 99%

<p>Cavotricuspid isthmus-dependent atrial flutter: clinical perspectives</p>

Bun¹,

Laţcu²,

Wedn³

et al. 2019

RRCC

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The precise circuit of cavotricuspid isthmus (CTI)-dependent atrial flutters (AFLs) has been well characterized, but the recent arrival of ultrahigh-resolution mapping systems has further improved our understanding of this "old" arrhythmia. CTI-dependent AFL may be the arrhythmia for which the electrocardiograph (ECG) correlation with the mechanism may be the highest. Once the diagnosis is made (predominantly based upon the surface ECG), the therapeutic options are precisely defined, with radiofrequency catheter ablation representing an efficient strategy with a high success rate and few complications. This article will focus on the clinical perspectives for CTI-dependent AFL.

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Contact-force-guided vs. contact-force-blinded catheter ablation of typical atrial flutter: a prospective study

Abstract: Catheter ablation of AFL guided by real-time CF assessment results in a significant reduction in total RF delivery time. Real-time CF measurements facilitate the maintenance of homogenous efficient contact all along the CTI, particularly in the anterior segment where CF is generally lower.

Cited by 18 publications

References 19 publications

Effectiveness and safety of high‐power and short‐duration ablation for cavotricuspid isthmus ablation in atrial flutter

Effectiveness and safety of high‐power and short‐duration ablation for cavotricuspid isthmus ablation in atrial flutter

Atrial Flutter: up‐to‐date Problem Evaluation with Clinical Positions

<p>Cavotricuspid isthmus-dependent atrial flutter: clinical perspectives</p>

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