The deeper the pouch is, the longer the radiofrequency duration and higher the radiofrequency energy needed-Cavotricuspid isthmus ablation using intracardiac echocardiography

Journal of Arrhythmia
Yukiko ShimizuYukihito Sato

Abstract

The aim of this study was to explore whether the pouch depth influenced the radiofrequency (RF) duration and total delivered RF energy for cavotricuspid isthmus (CTI) ablation and define the cutoff value for a deep pouch-specified ablation strategy. This study included 94 atrial fibrillation (AF) patients (56 males, age 68 ± 8.0 years). With intracardiac echocardiography, the isthmus length and pouch depth were precisely measured. After a standard AF ablation, all patients underwent the CTI ablation along the lateral isthmus. If bidirectional block could not be achieved, the ablation catheter was deflected more than 90 degrees to ablate inside the pouch (knuckle-curve ablation). Seventy-two patients (76.6%) had a sub-Eustachian pouch. Bidirectional block could be achieved in all patients. By a univariate logistic regression analysis, only the pouch depth was significantly correlated with the RF duration (P = .005) and RF energy (P = .006). A multivariate logistic regression analysis also revealed the pouch depth was the sole factor that influenced the RF duration (P = .001) and RF energy (P = .001). Among the 72 patients, 21 patients needed a knuckle-curve ablation. Using a receiver operating characteristic curve, the optimal c...Continue Reading

References

Aug 6, 2004·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·Marco ScaglioneFiorenzo Gaita
Nov 4, 2006·Journal of Cardiovascular Electrophysiology·Shih-Lin ChangShih-Ann Chen
Jan 27, 2007·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Yasuo OkumuraSatoshi Saito
Aug 12, 2008·Journal of Cardiovascular Electrophysiology·Li-Wei LoShih-Ann Chen
Apr 24, 2009·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Róbert PapLászló Sághy
Jul 19, 2011·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Jan-Yow ChenShoei K Stephen Huang
Jul 21, 2012·Journal of Cardiovascular Electrophysiology·Gábor BencsikLászló Sághy

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