Long‐Term Outcome of Radiofrequency Catheter Ablation for Topical Atrial Flutter: Risk Prediction of Recurrent Arrhythmias

Tai, Ching Tai; Chen, Shih Ann; Chiang, Chern En; Lee, Shih Huang; Wen, Zu Chi; Huang, Jin Long; Chen, Yi Jen; Yu, Wen Chung; Feng, An Ning; Lin, Yu Jen; Ding, Yu An; Chang, Mau Song

doi:10.1111/j.1540-8167.1998.tb00892.x

Cited by 160 publications

(117 citation statements)

References 17 publications

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“…25,26 In patients with episodes of both AFl and AF, flutter ablation may have different effects on the incidence of AF. [27][28][29] Nabar et al 30 noted a marked reduction in AF episodes after flutter ablation in patients with AFl as their dominant arrhythmia. This was not observed when AF occurred more often than AFl.…”

Section: Wellens Contemporary Management Of Atrial Fluttermentioning

confidence: 99%

Contemporary Management of Atrial Flutter

Wellens

2002

Circulation

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Section: Wellens Contemporary Management Of Atrial Fluttermentioning

confidence: 99%

Contemporary Management of Atrial Flutter

Wellens

2002

Circulation

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“…10,15,16) Initially, the activation mapping technique was used to show complete craniocaudal activation pattern of the opposite wall to the pacing. 7,8) Subsequently, complete CTI block was considered when a complete corridor of parallel double potentials from the right ventricle to the IVC was achived. 15) However, the presence of a very slow, persistent conduction through the ablation line can be misdiagnosis by both techniques; thus differential pacing techniques must shown, and these wavefronts were collided at the lower lateral right atrium.…”

Section: Criteria Of Complete Cti Conduction Blockmentioning

confidence: 99%

“…13,14) The preset duration of each radiofrequency (RF) pulse was 60 seconds. The RF energy was applied during a pullback of the ablation catheter from the right ventricle to the inferior vena cava (IVC), to create linear lesions.…”

Section: Rfamentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] Although activation mapping using the halo catheter may be the gold standard for detecting complete CTI block, transverse conduction across the crista terminalis (CT) will affect the activation sequence around the tricuspid valve mimicking incomplete CTI block. 9,10) Recently, a non-contact mapping (NCM) system has helped to determine the three-dimensional location of the ablation lesion accurately and reconstructs local virtual unipolar electrograms.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Virtual Unipolar Electrogram Voltage and Characteristics of Isthmus Block during Radiofrequency Ablation of Typical Atrial Flutter

Takahashi

Watanabe

Kofune

et al. 2015

Nichidai Igaku Zasshi

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Background:The optimal technique for recording of the electrogram to detect complete cavo-tricuspid isthmus (CTI) block during radiofrequency ablation (RFA) of the typical atrial flutter (AFL) using non-contact mapping system remains unclear. The aim of this study was to investigate the characteristics of the local virtual unipolar electrogram recorded at the ablation line during coronary sinus pacing after RFA of the CTI.Methods: Non-contact mapping was performed in 8 patients with AFL. Non-contact virtual unipolar electrograms were obtained before and after CTI linear ablation. All unipolar electrograms were acquired with both wide-band (0.5-300 Hz and 0.5-IC 150 Hz) and narrow-band filtering (32-300 Hz). The unipolar electrogram measurements included both the peak-to-peak voltage and peak-negative voltage for both filter settings, and the morpho logical characteristics of the second component of double potentials.Results: Comparison of the electrogram voltage along the ablation line before and after ablation demonstrated: 1) peak-negative voltage reduction at the mid-portion of the ablation line by 0.5-IC 150 Hz filtering, and 2) the second component of unipolar electrogram morphologies of R, Rs or rSR were the most sensitive and specific recording technique to predict conduction block.Conclusions: Non-contact unipolar electrograms using the peak-negative voltage with 0.5-IC 150 Hz and a predominant R-wave pattern in the second component at the ablation line indicate complete CTI block, even in the presence of transcristal conduction.

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“…[1][2][3][4][5][6][7] But, in the clinical setting, AFL and atrial fibrillation (AF) often coexist, and the follow up of patients successfully treated with transisthmic ablation is complicated by the occurrence of AF in 10～47% of patients. [8][9][10][11][12][13][14][15][16][17] We already have known that the presence of preablation AF is the most significant predictor of postablation AF. [18][19][20] However, clinical and procedural predictors of postablation AF occurrence has always been evaluated in the mixed group of AFL patients with AF [18][19][20] and rarely in the group of patients without history of AF.…”

Section: Introductionmentioning

confidence: 99%

The Difference of Left Atrial Volume Index: Can It Predict the Occurrence of Atrial Fibrillation after Radiofrequency Ablation of Atrial Flutter?

Kim

Kang

et al. 2007

Yeungnam Univ J Med

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-AbstractBackground：The occurrence of atrial fibrillation after ablation of atrial flutter is clinically important. We investigated variables predicting this evolution in ablated patients without a previous atrial fibrillation history.Materials and Methods：Thirty-six patients (Male=28) who were diagnosed as atrial flutter without previous atrial fibrillation history were enrolled in this study. Group 1 (n=11) was defined as those who developed atrial fibrillation after atrial flutter ablation during 1 year follow-up. Group 2 (n=25) was defined as those who has not occurred atrial fibrillation during same follow-up term. Echocardiogram was performed to all patients. We measured left atrial size, left ventricle end diastolic and systolic dimension, ejection fraction and left atrial volume index before and after ablation of atrial flutter. The differences of each variables were compared and analyzed between two groups. 1)Results：The preablation left ventricular ejection fraction (preLVEF) and postablation left ventricular ejection fraction (postLVEF) are 54±14%, 56±13% in group 1 and 47±16%, 52±13% in group 2. The differences between each two groups are statistically insignificant (2.2±1.5 in group 1 vs 5.4±9.8 in group 2, p=0.53). The preablation left atrial size (preLA) and postablation left atrial size (postLA) are 40±4 mm, 41±4 mm in group1 and 44±8 mm, 41±4 mm in group 2. The atrial sizes of both groups were increased but, the differences of left atrial size between two groups before and after flutter ablation were statistically insignificant (0.6±0. Conclusion：The difference between left atrial volume index before and after atrial flutter ablation is the robust predictor of occurrence of atrial fibrillation after atrial flutter ablation without previous atrial fibrillation.

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Long‐Term Outcome of Radiofrequency Catheter Ablation for Topical Atrial Flutter: Risk Prediction of Recurrent Arrhythmias

Cited by 160 publications

References 17 publications

Contemporary Management of Atrial Flutter

Contemporary Management of Atrial Flutter

Characteristics of Virtual Unipolar Electrogram Voltage and Characteristics of Isthmus Block during Radiofrequency Ablation of Typical Atrial Flutter

The Difference of Left Atrial Volume Index: Can It Predict the Occurrence of Atrial Fibrillation after Radiofrequency Ablation of Atrial Flutter?

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