Simple and efficient identification of conduction gaps in post-ablation recurring atrial flutters
Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Gabriel LaurentJean Eric Wolf
Abstract
Cavo-tricuspid isthmus (CTI) radiofrequency (RF) ablation is a curative therapy for common atrial flutter (AFl), but is associated with a recurrence rate of 5-26%. Although complete bidirectional conduction block is usually achieved, the recurrence of AF is due to recovered conducting isthmus tissue through which activation wavefronts pass. We evaluated a simple and efficient electrophysiological strategy, which pinpoints the ablation target. Twenty-five patients (19 men), mean age 61 +/- 6, with recurrent AFl required a repeat ablation, 250 +/- 160 days after a successful RF CTI procedure. Transverse CTI conduction was monitored during AFl or coronary sinus (CS) pacing by a 24-pole mapping catheter positioned in the right atrium (RA), with the distal poles in the CS, proximal poles on the lateral RA, and intermediate poles on the CTI. A slow conduction area traversing the CTI (velocity, 37 +/- 22 vs. 98 +/- 26 cm/s on either side, P < 0.05) and a lower potential amplitude than at both sides (0.2 +/- 0.15 vs. 0.5 +/- 0.5 mV, P < 0.05), defined by a bayonet-shaped depolarization sequence, were considered to represent the incomplete line of block (InLOB). An ablation catheter was progressively dragged up to this InLOB, from the t...Continue Reading
References
Jun 1, 1989·Pacing and Clinical Electrophysiology : PACE·D E Haines, D D Watson
May 1, 1995·Journal of the American College of Cardiology·T A SimmersR N Hauer
Dec 1, 1994·Circulation·G KirkorianP Touboul
Oct 1, 1993·Circulation·S NathD E Haines
Mar 15, 1993·The American Journal of Cardiology·F G CosioJ L Barroso
Nov 14, 1997·Circulation·D C ShahJ Clementy
Mar 25, 1998·Journal of Cardiovascular Electrophysiology·C T TaiM S Chang
Mar 25, 1998·Journal of Cardiovascular Electrophysiology·B SchumacherB Lüderitz
Jan 20, 1999·Circulation·D ShahJ Clémenty
Feb 6, 1999·Journal of the American College of Cardiology·H YamabeY Hokamura
Dec 22, 1999·Circulation·J ChenE Aliot
Feb 23, 2000·Circulation·P JaïsJ Clémenty
Apr 27, 2000·Japanese Circulation Journal·T HigumaK Okumura
Sep 27, 2000·Circulation·D ShahJ Clémenty
Mar 14, 2001·Circulation·F AnselmeN Saoudi
Mar 29, 2001·Pacing and Clinical Electrophysiology : PACE·F J ChorroL Such
Aug 31, 2001·Journal of the American College of Cardiology·H TadaF Morady
Oct 23, 2002·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Jian ChenOle-Jørgen Ohm
Aug 25, 2004·Circulation·Antoine Da CostaKarl Isaaz
Citations
Aug 2, 2007·Journal of Cardiovascular Medicine·Peter Andrew, Annibale S Montenero
Dec 25, 2015·Heart, Lung & Circulation·F Rey, H Sunthorn
Sep 12, 2009·Heart, Lung & Circulation·Ilker MataraciKaan Kirali