Correlation between electrogram morphology and standard criteria to validate bidirectional cavotricuspid block in common atrial flutter ablation.
Mariud Andronache,C. De Chillou,H. Miljoen,I. Magnin-Poull,Marc Messier,P. Dotto,Daniel Beurrier,T. Doan,P. Houriez,A. Bineau-Jorisse,B. Thiel,B. Brembilla-Perrot,J.-L. Massing,N. Sadoul,E. Aliot +14 more
TL;DR: The study suggests that morphological changes in BAE recorded at sites lateral and adjacent to the target line of block may be used as a unique and robust criterion to validate CTI conduction block during AF ablation procedure.
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Abstract: Aim Assessment of a bidirectional conduction block within the cavotricuspid isthmus (CTI) is critical during radiofrequency (RF) atrial flutter (AF) ablation. We investigated the use of bipolar atrial electrogram (BAE) morphology as an additional criterion identifying CTI block and tested it against two recognized criteria: differential pacing and reversal of the right atrial depolarization sequence during coronary sinus (CS) pacing. Methods and results An RF ablation procedure was performed during 600 ms CS pacing in 100 consecutive patients with a common AF. BAE recorded along the CTI were continuously monitored. CTI conduction block was achieved by RF ablation in all patients and a clear change in BAE polarity in the Electrogram recorded by the dipoles located on the CTI and immediately lateral to the intended line of block (RS to QR pattern) associated with a confirmed CTI conduction block was observed in all cases. BAE morphology changes predicted bidirectional CTI conduction blocks with a 100% positive and a 100% negative predictive value. At a mean follow-up of 33 11 months, there was a 5% AF recurrence rate. Conclusions Our study suggests that morphological changes in BAE recorded at sites lateral and adjacent to the target line of block may be used as a unique and robust criterion to validate CTI conduction block during AF ablation procedure.
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Citations
Long-Term Outcomes After Catheter Ablation of Cavo-Tricuspid Isthmus Dependent Atrial Flutter: A Meta-Analysis
Francisco J. Perez,Christine M. Schubert,Babar Parvez,Vishesh Pathak,Kenneth A. Ellenbogen,Mark A. Wood +5 more
TL;DR: In this paper, the authors performed a meta-analysis of articles reporting clinical outcomes after catheter ablation of cavotricuspid isthmus-dependent atrial flutter.
284
Anatomical Variations of the Coronary Sinus Ostium Area of the Human Heart
TL;DR: The frequency and variability of anatomical structures in the area of the coronary sinus ostium probably influence the haemodynamics of this area and knowledge of and being able to identify these anatomical variations may help in identifying and overcoming potential difficulties in treating arrythmias and in cardiosurgery.
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•Journal Article
An approach to catheter ablation of cavotricuspid isthmus dependent atrial flutter.
Mark D O'Neill,Pierre Jaïs,Anders Jönsson,Yoshihide Takahashi,Frederic Sacher,Mélèze Hocini,Prashanthan Sanders,Thomas Rostock,Martin Rotter,Jacques Clémenty,Michel Haïssaguerre +10 more
TL;DR: In this paper, the authors proposed a catheter ablation procedure for CTI-dependent atrial tachycardia, targeting the critical isthmus of tissue located between the tricuspid annulus and the inferior vena cava.
12
Radio-Frequency Ablation of Atrial Flutter: Long-Term Results and Predictive Value of Cavo-Tricuspid Isthmus Bidirectional Block as Determined by a Simplified Technique
Philippe Maury,F. Raczka,Denis Gaty,Alexandre Duparc,Philippe Couderc,Lucy Hollington,Celse D,Marc Delay,Jean-Marie Fauvel,Jacques Puel,Jean-Marc Davy +10 more
TL;DR: Long-term results of CTI ablation, employing a simplified method using the differential pacing technique, are similar to those for the standard methods using multipolar catheters, therefore this technique compares favorably to other established methods for such common RF procedures, especially due to its lower cost.
11
Anatomical peculiarities of the cavo-tricuspid isthmus in the human heart.
Božena Pejković,Ivan Krajnc +1 more
TL;DR: Knowing and recognizing certain anatomical peculiarities of the structures in this part of the right atrium may be interesting for clinical practice.
10
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Differential Pacing for Distinguishing Block From Persistent Conduction Through an Ablation Line
TL;DR: An accurate assessment of isth Mus block or persistent isthmus conduction is possible with this technique of differential pacing.
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Double potentials along the ablation line as a guide to radiofrequency ablation of typical atrial flutter.
Hiroshi Tada,Hakan Oral,Christian Sticherling,Steven P. Chough,Robert L. Baker,Kristina Wasmer,Frank Pelosi,Bradley P. Knight,S. Adam Strickberger,Fred Morady +9 more
TL;DR: Detailed analysis of DPs is helpful in identifying gaps in the ablation line and in distinguishing complete from incomplete isthmus block in patients undergoing radiofrequency ablation of typical AFL.
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Cavotricuspid Isthmus Mapping to Assess Bidirectional Block During Common Atrial Flutter Radiofrequency Ablation
Jian Chen,Christian de Chillou,Tarek Basiouny,Nicolas Sadoul,Jorge Da Silva Filho,I. Magnin-Poull,Marc Messier,Etienne Aliot +7 more
TL;DR: This study establishes that reversal of the atrial depolarization sequence up to the LOB is a definitive and mandatory criteria of successful atrial flutter ablation.
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Catheter ablation of typical atrial flutter: a randomized comparison of 2 methods for determining complete bidirectional isthmus block.
TL;DR: Although feasible, the on-site atrial potential analysis seemed to be inferior to the classic activation mapping technique, mainly because of the ambiguity of electrogram interpretation along the ablation line, therefore, optimally, both methods should be used concomitantly.
102