Effect of isthmus anatomy and ablation catheter on radiofrequency catheter ablation of the cavotricuspid isthmus

Cavotricuspid isthmus (CTI) characteristics are rarely documented when comparing catheters in radiofrequency ablation (RFA) of atrial flutter (AFL). Our objectives were (1) to evaluate the impact of CTI morphology and length on ablation procedures and (2) to compare the efficacy of an 8-mm-tip cathe...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2004-08, Vol.110 (9), p.1030-1035
Main Authors: DA COSTA, Antoine, FAURE, Emmanuel, THEVENIN, Jérome, MESSIER, Marc, BERNARD, Samuel, ABDEL, Kihel, ROBIN, Christophe, ROMEYER, Cécile, ISAAZ, Karl
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Atrial Fibrillation - epidemiology
Atrial Fibrillation - prevention & control
Atrial Flutter - pathology
Atrial Flutter - surgery
Biological and medical sciences
Blood and lymphatic vessels
Bones, joints and connective tissue. Antiinflammatory agents
Cardiology. Vascular system
Cardiovascular system
Catheter Ablation - instrumentation
Cineangiography
Cold Temperature
Contrast Media
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Electrocardiography
Female
Heart Atria - diagnostic imaging
Heart Atria - pathology
Humans
Life Tables
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Prospective Studies
Tricuspid Valve - diagnostic imaging
Tricuspid Valve - pathology
Vasodilator agents. Cerebral vasodilators
Venae Cavae - diagnostic imaging
Venae Cavae - pathology
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Description
Summary:Cavotricuspid isthmus (CTI) characteristics are rarely documented when comparing catheters in radiofrequency ablation (RFA) of atrial flutter (AFL). Our objectives were (1) to evaluate the impact of CTI morphology and length on ablation procedures and (2) to compare the efficacy of an 8-mm-tip catheter with an irrigated cooled-tip RFA in the subgroup presumed to be more difficult to treat (with a long CTI, >35 mm). Over a period of 17 months, 185 patients accepted the protocol and underwent an isthmogram in preparation for RFA. Groups were classified according to CTI length and CTI morphology. RFA was performed with an 8-mm-tip catheter for patients with a short CTI, < or =35 mm (n=123), whereas randomization between an 8-mm-tip and a cooled-tip catheter applied to patients with a longer CTI, >35 mm (n=62). For long CTI, 32 patients were assigned to an 8-mm catheter and 30 patients to the cooled-tip RFA ablation group. In this subset, RF application (18.2+/-17 versus 19+/-13 minutes) and x-ray exposure (20.8+/-18 versus 18+/-13 minutes) did not differ between the 8-mm-tip and the cooled-tip procedures. Number of applications (9.9+/-11 versus 18.6+/-15 minutes; P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.0000139845.40818.75