![]() This simplified RF ablation of common atrial flutter is feasible with a low recurrence rate. Surface ECG criteria combined with mapping of the line of block demonstrate evidence of bi-directional IVCT block. After a follow-up of 16 +/- 4 months there was no recurrence of atrial flutter. Conduction evaluated with the Halo catheter showed bi-directional complete block in these 29 patients. Mapping the line of lesions showed a complete corridor of parallel double potentials in these 26 cases and in 3 of the 4 patients in whom ECG criteria were not met. Surface ECG criteria were met in 26 patients. Finally, the block was reassessed with a 'Halo' catheter. ![]() ![]() Otherwise the procedure was stopped if mapping showed parallel double potentials all along the line. Additional RF lesions were applied if mapping disclosed a zone of residual conduction. Then, the line of lesions was mapped during atrial pacing with the RF catheter. The end point during low lateral atrial pacing was an increment in the interval between the pacing artefact and the peak of the R wave in surface lead II >50 ms and clockwise rotation of the P wave axis beyond -30 degrees and inferiorly. Surface ECG criteria were used to monitor the conduction within the IVCT. RF ablation lesions were created in the IVCT. Radio frequency (RF) ablation of common atrial flutter was performed in 30 patients with the sole use of a catheter for atrial pacing and a RF catheter. The aim of this study was prospectively to test the feasibility of a simplified ablation procedure using only two catheters. However, its demonstration requires the use of several electrode catheters and mapping of the line of block. Intra- atrial conduction block within the inferior vena cava-tricuspid annulus isthmus (IVCT) has been shown to predict successful common atrial flutter ablation. Klug, D Lacroix, D Marquié, C Mairesse, G Alix, D Dennetière, S d'Hautefeuille, B Zghal, N Kacet, S Prospective evaluation of a simplified approach for common atrial flutter radio frequency ablation with only two catheters. Electrophysiological findings and catheter ablation of the arrhythmia are highlighted. Mechanistic and clinical characteristics as well as management of isthmus-dependent atrial flutter are described in detail. Catheter ablation of the cavotricuspid isthmus represents the primary choice in long-term therapy, associated with high procedural success (> 97 %) and low complication rates (0.5 %).This article represents the third part of a manuscript series designed to improve professional education in the field of cardiac electrophysiology. Acutely symptomatic cases may be subjected to cardioversion or pharmacologic rate control to relieve symptoms. The risk of thromboembolism is probably similar to atrial fibrillation therefore, the same antithrombotic prophylaxis is required in atrial flutter patients. Concomitant heart failure or pulmonary disease further increases the risk of typical atrial flutter.Patients with atrial flutter may present with symptoms of palpitations, reduced exercise capacity, chest pain, or dyspnea. For patients undergoing atrial flutter ablation, there was progressive temporal recovery of CSNRT (1,204 +/- 671 msec at baseline vs 834 +/- 380 msec at 3 months P  80 years of age. P wave amplitude and duration, and percent atrial sensing also were assessed at the same intervals. CSNRT then was measured in the same manner at 48 hours, 14 days, and 3 months after ablation/pacemaker implantation. Within 24 hours of ablation or pacemaker implantation, baseline maximal CSNRT was measured through a permanent pacemaker by AAI pacing at six cycle lengths: 600, 550, 500, 450, 400, and 350 msec. The control group consisted of 11 patients who were undergoing pacemaker implantation for sinus node disease but did not have a history of atrial dysrhythmias or ablation. After ablation, there was abnormal sinus node function defined as a corrected sinus node recovery time (CSNRT) > or = 550 msec. Twenty-four patients (16 men and 8 women age 68 +/- 11 years) were referred for ablation of persistent atrial flutter (duration 8 +/- 11 months). The purpose of this study was to investigate the effect of ablation of right atrial flutter upon sinus node function in humans. Remodeling of sinus node function after catheter ablation of right atrial flutter.ĭaoud, Emile G Weiss, Raul Augostini, Ralph S Kalbfleisch, Steven J Schroeder, Jason Polsinelli, Georgia Hummel, John D
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