Patel NJ, Deshmukh A, Pau D, Goyal V, Patel SV, Patel N, et al. Differential pacing for distinguishing block from persistent conduction through an ablation line. Shah D, Haissaguerre M, Takahashi A, Jais P, Hocini M, Clementy J. European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardiaca y Electrofisiologia (SOLAECE). Katritsis DG, Boriani G, Cosio FG, Hindricks G, Jaïs P, Josephson ME, et al.
#Cti ablation flutter trial
Clinical trial registrationĪtrial Flutter Ablation in a Real World Population. The use of an ablation catheter equipped with mini-electrodes technology seems to improve ablation efficiency. ConclusionsĪblation was highly effective in achieving acute CTI BDB and long-term arrhythmia freedom irrespective of the ablation strategy or the validation criteria for CTI chosen by the operator. No differences were found according to BDB achieved by both validation criteria. During a mean follow-up of 548 ± 304 days, 32 (6.2%) patients suffered an AFL recurrence. Fluoroscopy time was similar among groups, whereas we observed a reduction in the procedure duration from the BLZ Conv group (61.9 ± 26min) to the MiFi MVG group (50.6 ± 17min, p = 0.048). The number of RF applications needed to achieve BDB was lower in the MiFi MVG group vs both the MiFi Conv group and the BLZ Conv group (3.2 ± 2 vs 5.2 ± 4 vs 9.3 ± 5, p < 0.0001 for all comparisons). ResultsĬomplete BDB according to both validation criteria (sequential detailed activation mapping or mapping only the ablation site) was achieved in 443 patients (88.6%). Patients were grouped on the basis of the AFL ablation method (linear anatomical approach, Conv group n = 425, or maximum voltage guided, MVG group, n = 75) and ablation catheter (mini-electrodes technology, MiFi group, n = 254, or a standard 8-mm ablation catheter, BLZ group, n = 246). We evaluated the acute and long-term outcome of CTI ablation aiming at bidirectional conduction block (BDB) in a prospective, multicenter cohort study enrolling 500 patients indicated for typical AFL ablation. This meta-analysis shows addition of a prophylactic PVI during CTI ablation significantly reduces recurrent AA at 1 year without significantly increasing major complications.Ītrial arrhythmias atrial fibrillation atrial fibrillation ablation atrial flutter atrial flutter ablation.A novel ablation catheter has been released to map and ablate the cavo-tricuspid isthmus (CTI) in patients with atrial flutter (AFL), improving ablation efficiency. Total complications were statistically similar between groups. Procedure time and fluoroscopy time were significantly longer in the CTI + PVI group (mean difference : 103.31 min 95% CI, P < 0.00001) and (MD: 16.47 min 95% CI, P < 0.00001), respectively. A total of 550 patients (n = 336 CTI, n = 214 CTI + PVI) were included in analyses for procedure time, fluoroscopy time, and complications rates. Freedom from AA at 1 year was significantly higher in the CTI + PVI group versus CTI alone (odds ratio 0.25 95% confidence interval, P < 0.00001). In the recurrent AA analysis, a total of 314 patients were randomized in the studies (n = 158 CTI, n = 156 CTI + PVI). All patients were included in the analyses of other clinical outcomes.įour randomized control trials were included in the meta-analysis. Only patients without prior history of AF were included in the recurrent AA analysis. PubMed and Google Scholar were searched for randomized trials comparing the incidence of AA after CTI versus CTI + PVI until June 2018. These studies were analyzed to determine the overall effect of this approach on recurrent AA. Several studies have examined the effect of performing concomitant pulmonary vein isolation (PVI) with CTI on recurrent AA. Atrial arrhythmias (AA), including atrial fibrillation (AF), have been reported in patients after cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFL).
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