Premium
High Energy Radiofrequency Catheter Ablation for Common Atrial Flutter Targeting the Isthmus between the Inferior Vena Cava and Tricuspid Valve Annulus Using a Super Long Tip Electrode
Author(s) -
IESAKA YOSHITO,
TAKAHASHI ATSUSHI,
GOYA MASAHIKO,
YAMANE TEIICHI,
TOKUNAGA TAKESHI,
AMEMIYA HIROSHI,
FUJIWARA HIDEOMI,
NITTA JUNICHI,
NOGAMI AKIHIKO,
AONUMA KAZUTAKA,
HIROE MICHIAKI,
MARUMO FUMIAKI,
HIRAOKA MASAYASU
Publication year - 1998
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1998.tb00064.x
Subject(s) - medicine , atrial flutter , inferior vena cava , tricuspid valve , ablation , cardiology , catheter ablation , annulus (botany) , radiofrequency ablation , atrial fibrillation , catheter , anatomy , surgery , botany , biology
There have been controversies concerning the optimal target sites and approaches in radiofre‐quency catheter ablation of common atrial flutter. We attempted high energy radiofrequencv catheter ab‐lation targeting the isthmus between the inferior vena cava and tricuspid valve annulus (IVC‐TV isthmus) with a super long (8 mm) tip electrode, and compared the efficacy of this anatomical approach with the electrophysiological approach targeting the posteroseptal right atrium posterior to the coronary sinus us‐ing a standard 4‐mm tip electrode. Atrial flutter was successfully ablated in 12 of 12 patients (100%) with‐out recurrence with the anatomical approach, while, in 7 of 9 patients (64%) with 2 recurrences with the electrophysiological approach. In comparison of ablation data between the anatomical and electrophysi‐ological approaches, there were significant differences in the mean number of application pulses (anatomical vs electrophysiological: 2.3 ± 0.8 vs 9.9 ± 6.4, P < 0.01), applied wattage (39 ± 12Wvs24 ± 6W.P < 0.01), applied energy per application (1.986 ± 426 / vs 659 ± 323 J. P < O.O1), fluoroscopic time (26 ± 11 min vs 74 ± 30 minutes, P < 0.01), and procedure time (59 ± 8 min vs 181 ± 53 min. P < 0.01). In conclusion, the anatomical approach is superior to the electrophysiological one with respect to proce‐dure and radiation time, and linear ablation at the IVC‐TV isthmus with an 8‐wm tip electrode and high energy application is highly effective and safe.