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

Kwon, Hee Jin; Lee, Seong Soo; Park, Young Jun; Park, Seung‐Jung; Park, Kyoung-Min; Kim, June Soo; On, Young Keun

doi:10.1111/pace.14019

Cited by 6 publications

(4 citation statements)

References 22 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies, HPSD ablation has been demonstrated to be as effective as conventional power for PVI, notably with a higher rate of first‐round PVI, lower procedural and radiofrequency duration, and overall low procedural complication rate 1–5,16–19 . Besides PVI, HPSD has been recently described for posterior wall isolation 20 and cavotricuspid isthmus (CTI) ablation 21 …”

Section: Discussionmentioning

confidence: 99%

Ablation Index‐guided high‐power (50 W) short‐duration for left atrial anterior and roofline ablation: Feasibility, procedural data, and lesion analysis (AI High‐Power Linear Ablation)

Zanchi

Chen

Bordignon

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Objectives To evaluate the feasibility, procedural data, and lesion characteristics of the anterior line (AL) and roofline (RL) ablation by using ablation index (AI)‐guided high power (50 W) among patients with recurrent atrial fibrillation (AF) or atrial tachycardia (AT) after pulmonary vein isolation (PVI). Methods Data from 35 consecutive patients with macro‐reentrant left atrial tachycardia or substrate at the left atrium anterior wall or roof after previous PVI were collected. Ablation power was set to 50 W, targeting AI 500 for AL and 400 for RL. The first‐pass conduction block (FPB) was evaluated. The AL was arbitrarily divided into three (caudal, middle, and cranial) segments to analyze the location of conduction gaps in non‐FPB patients. Results A total of 32 AL and 17 RL were deployed and FPB was achieved in 24 (75%) and 14 (82%) of them, respectively. In the non‐FPB group, the most frequent gap location along the AL was the middle third. The final block of AL was achieved in 97%, and the block of RL was achieved in 100%. The radiofrequency (RF) ablation time was short (2.9 ± 0.8 min for AL and 46.2 ± 15.6 s for RL). For AL, the female gender was significantly more frequent in FPB than in non‐FPB patients (p = .028); patients with non‐FPB were associated with significantly longer RF time as compared to patients with FPB (204 ± 47 s vs. 161 ± 41 s; p = .02). No procedural complications occurred. Conclusion AI‐guided high‐power (50 W) ablation appears to be a feasible, effective, and fast technique for AL and RL ablation.

show abstract

Section: Discussionmentioning

confidence: 99%

Ablation Index‐guided high‐power (50 W) short‐duration for left atrial anterior and roofline ablation: Feasibility, procedural data, and lesion analysis (AI High‐Power Linear Ablation)

Zanchi

Chen

Bordignon

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…[36][37][38] However, in AFL patients, the ATAs can be found in 16.7-50% of patients after CTI ablation. 39,40 The Link Between Atrial Flutter and AF…”

Section: Main Results and The Current Recommendationmentioning

confidence: 99%

Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysis

Waranugraha

Rizal

Rohman

et al. 2022

Arrhythm Electrophysiol Rev

View full text Add to dashboard Cite

Background: The advantage of prophylactic cavotricuspid isthmus (CTI) ablation for AF patients without documented atrial flutter is still unclear. The present study aimed to evaluate the role of prophylactic CTI ablation in this population. Methods: A systematic review and meta-analysis study was conducted. The overall effects estimation was conducted using random effects models. The pooled effects were presented as the risk difference and standardised mean difference for dichotomous and continuous outcomes, respectively. Results: A total of 1,476 patients from four studies were included. The risk of atrial tachyarrhythmias following a successful catheter ablation procedure was greater in the pulmonary vein isolation + CTI ablation group than pulmonary vein isolation alone group (34.8% versus 28.2%; risk difference 0.08; 95% CI [0.00–0.17]; p=0.04). Prophylactic CTI ablation was associated with a higher recurrent AF rate (33.8% versus 27.1%; risk difference 0.07; 95% CI [0.01–0.13]; p=0.02). Additional prophylactic CTI ablation to pulmonary vein isolation significantly increased the radio frequency application time (standardised mean difference 0.52; 95% CI [0.04–1.01]; p=0.03). Conclusion: This study suggested that prophylactic CTI ablation was an ineffective and inefficient approach in AF without documented typical atrial flutter patients.

show abstract

“…The main concern about vHPSD is the lack of transmurality in regions with thicker tissue like the CTI 45 . However, data utilizing 50 W in studies by Kwon et al and Yavin et al reported a success rate for CTI block of 100% 46,47 …”

Section: Pulmonary Vein Isolation Utilizing the Qdot Micro™ Cathetermentioning

confidence: 99%

Very high‐power short‐duration catheter ablation for treatment of cardiac arrhythmias: Insights from the FAST and FURIOUS study series

Heeger,

Kuck,

Tilz

2023

Cardiovasc electrophysiol

View full text Add to dashboard Cite

The QDOT MICRO™ Catheter is a novel open‐irrigated contact force‐sensing radiofrequency ablation catheter. It offers very high‐power short‐duration (vHPSD) ablation with 90 W for 4 s to improve safety and efficacy of catheter ablation procedures. Although the QDOT MICRO™ Catheter was mainly designed for pulmonary vein isolation (PVI) its versatility to treat atrial fibrillation (AF) and other types of arrhythmias was recently evaluated by the FAST and FURIOUS study series and other studies and will be presented in this article. Available study and registry data as well as case reports concerning utilization of the QDOT MICRO™ Catheter for the treatment of cardiac arrhythmias including AF, focal and macroreentry atrial tachycardia, typical atrial flutter by cavotricuspid isthmus block, premature ventricular contractions, and accessory pathways were reviewed and summarized. In summary, the QDOT MICRO™ Catheter showed safety and efficacy for PVI and is able to treat also other types of arrhythmias as is was recently evaluated by case reports and the FAST and FURIOUS studies.

show abstract

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

Cited by 6 publications

References 22 publications

Ablation Index‐guided high‐power (50 W) short‐duration for left atrial anterior and roofline ablation: Feasibility, procedural data, and lesion analysis (AI High‐Power Linear Ablation)

Ablation Index‐guided high‐power (50 W) short‐duration for left atrial anterior and roofline ablation: Feasibility, procedural data, and lesion analysis (AI High‐Power Linear Ablation)

Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysis

Very high‐power short‐duration catheter ablation for treatment of cardiac arrhythmias: Insights from the FAST and FURIOUS study series

Contact Info

Product

Resources

About